| Upstate Geriatric Medical Services Pc | |
|
7915 Metropolitan Ave Middle Village NY 11379-2930 | |
| (516) 806-2544 | |
| (516) 806-2538 |
| Full Name | Upstate Geriatric Medical Services Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 7915 Metropolitan Ave, Middle Village, New York |
| Authorized Official Name and Position | Ion Oltean (OWNER) |
| Authorized Official Contact | 5168062544 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Upstate Geriatric Medical Services Pc 7915 Metropolitan Ave Middle Village NY 11379-2930 Ph: (516) 806-2544 | Upstate Geriatric Medical Services Pc 7915 Metropolitan Ave Middle Village NY 11379-2930 Ph: (516) 806-2544 |
| NPI Number | 1225602675 |
|---|---|
| Provider Enumeration Date | 05/19/2021 |
| Last Update Date | 05/19/2021 |
| Medicare PECOS PAC ID | 6406255884 |
|---|---|
| Medicare Enrollment ID | O20210604002514 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225602675 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Ion Oltean |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1184729113 PECOS PAC ID: 2163486432 Enrollment ID: I20041228000459 |
| Provider Name | Svetlana Fuzaylova |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003911033 PECOS PAC ID: 7719997063 Enrollment ID: I20060502000080 |
| Provider Name | Rosanna Paknoush |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750880142 PECOS PAC ID: 5294087144 Enrollment ID: I20181004001294 |
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