Provider Demographics
NPI:1336515675
Name:GOOD HEALTH MEDICAL CARE PLLC
Entity Type:Organization
Organization Name:GOOD HEALTH MEDICAL CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D
Authorized Official - Prefix:
Authorized Official - First Name:ALTAF
Authorized Official - Middle Name:H
Authorized Official - Last Name:SHAIK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-216-5767
Mailing Address - Street 1:4370 KISSENA BLVD
Mailing Address - Street 2:APT 2D
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-3769
Mailing Address - Country:US
Mailing Address - Phone:718-216-5767
Mailing Address - Fax:718-303-0763
Practice Address - Street 1:4370 KISSENA BLVD
Practice Address - Street 2:APT 2D
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-3769
Practice Address - Country:US
Practice Address - Phone:718-216-5767
Practice Address - Fax:718-303-0763
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-20
Last Update Date:2015-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY252163-1207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty