| Sunny Friendly Medical Pc | |
|
4199 Main St Ste 201 Flushing NY 11355-3821 | |
| (718) 961-1897 | |
| Not Available |
| Full Name | Sunny Friendly Medical Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 4199 Main St Ste 201, Flushing, New York |
| Authorized Official Name and Position | Xiaoyan Song (OWNER) |
| Authorized Official Contact | 6464003589 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sunny Friendly Medical Pc 4199 Main St Ste 201 Flushing NY 11355-5164 Ph: (718) 961-1897 | Sunny Friendly Medical Pc 4199 Main St Ste 201 Flushing NY 11355-3821 Ph: (718) 961-1897 |
| NPI Number | 1285077123 |
|---|---|
| Provider Enumeration Date | 04/10/2013 |
| Last Update Date | 07/25/2024 |
| Medicare PECOS PAC ID | 7113156324 |
|---|---|
| Medicare Enrollment ID | O20140211001328 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285077123 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 267041 (New York) | Primary |
| Provider Name | Xiaoyan Song |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1821368390 PECOS PAC ID: 4385884030 Enrollment ID: I20130701000638 |
| Provider Name | Wan Tu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932762051 PECOS PAC ID: 4486036340 Enrollment ID: I20220809002408 |
| Provider Name | Dana D Chen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366035685 PECOS PAC ID: 2062883457 Enrollment ID: I20230123001200 |
| Provider Name | Pao-ju Tseng |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386163012 PECOS PAC ID: 2860875648 Enrollment ID: I20230130001666 |
| Provider Name | Jing Bo Wu |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013449800 PECOS PAC ID: 0244656619 Enrollment ID: I20230224001002 |
| Provider Name | Xue Xu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417455569 PECOS PAC ID: 1355874223 Enrollment ID: I20241030003052 |
| Provider Name | Li Xie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629814819 PECOS PAC ID: 3375076078 Enrollment ID: I20241104000638 |
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