Provider Demographics
NPI:1043439680
Name:FINECARE MEDICAL MANAGEMENT, INC
Entity Type:Organization
Organization Name:FINECARE MEDICAL MANAGEMENT, INC
Other - Org Name:FINECARE MEDICAL LABORTORY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:MR
Authorized Official - First Name:IRFAN
Authorized Official - Middle Name:S
Authorized Official - Last Name:CHAUDHRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-628-9800
Mailing Address - Street 1:5907 71ST AVE
Mailing Address - Street 2:
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:11385-5655
Mailing Address - Country:US
Mailing Address - Phone:718-628-9800
Mailing Address - Fax:718-628-1810
Practice Address - Street 1:5907 71ST AVE
Practice Address - Street 2:
Practice Address - City:RIDGEWOOD
Practice Address - State:NY
Practice Address - Zip Code:11385-5655
Practice Address - Country:US
Practice Address - Phone:718-628-9800
Practice Address - Fax:718-628-1810
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-24
Last Update Date:2008-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY7977291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04902Medicare PIN