| Tri City Medical Pc | |
|
5812 Queens Blvd # 21281 Woodside NY 11377-7765 | |
| (929) 224-2588 | |
| (917) 818-4288 |
| Full Name | Tri City Medical Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 5812 Queens Blvd # 21281, Woodside, New York |
| Authorized Official Name and Position | Jin Lee (ADMINISTRATOR) |
| Authorized Official Contact | 9292242588 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tri City Medical Pc 5812 Queens Blvd # 21281 Woodside NY 11377-7765 Ph: (929) 224-2588 | Tri City Medical Pc 5812 Queens Blvd # 21281 Woodside NY 11377-7765 Ph: (929) 224-2588 |
| NPI Number | 1639824816 |
|---|---|
| Provider Enumeration Date | 02/16/2022 |
| Last Update Date | 05/19/2025 |
| Medicare PECOS PAC ID | 9638563158 |
|---|---|
| Medicare Enrollment ID | O20220228000918 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639824816 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
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