Provider Demographics
NPI:1043499817
Name:PREFERRED HEALTH MEDICAL CARE PC
Entity Type:Organization
Organization Name:PREFERRED HEALTH MEDICAL CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:FARZIN
Authorized Official - Middle Name:
Authorized Official - Last Name:SEHATI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:718-736-1450
Mailing Address - Street 1:PO BOX 234809
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11023-4809
Mailing Address - Country:US
Mailing Address - Phone:718-736-1450
Mailing Address - Fax:
Practice Address - Street 1:6902 AUSTIN ST FL 3
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-4233
Practice Address - Country:US
Practice Address - Phone:718-263-1450
Practice Address - Fax:718-263-1454
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-30
Last Update Date:2019-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY204917207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY06866Medicare PIN
NYG99969Medicare UPIN