Provider Demographics
NPI:1164757704
Name:COMMUNITY MEDICAL CARE OF N.Y., P.C.
Entity Type:Organization
Organization Name:COMMUNITY MEDICAL CARE OF N.Y., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AHMAD
Authorized Official - Middle Name:
Authorized Official - Last Name:RIAZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-294-5000
Mailing Address - Street 1:1963 GRAND CONCOURSE
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10453-4994
Mailing Address - Country:US
Mailing Address - Phone:718-294-5000
Mailing Address - Fax:718-294-6060
Practice Address - Street 1:1963 GRAND CONCOURSE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10453-4994
Practice Address - Country:US
Practice Address - Phone:718-294-5000
Practice Address - Fax:718-294-6060
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-15
Last Update Date:2009-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY196049261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01548287Medicaid