Provider Demographics
NPI:1346869971
Name:ATLAS MEDICAL CARE PC
Entity Type:Organization
Organization Name:ATLAS MEDICAL CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SARA
Authorized Official - Middle Name:
Authorized Official - Last Name:SAFDAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:347-322-2284
Mailing Address - Street 1:171 STRATFORD N
Mailing Address - Street 2:
Mailing Address - City:ROSLYN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11577-2343
Mailing Address - Country:US
Mailing Address - Phone:347-322-2284
Mailing Address - Fax:718-693-7770
Practice Address - Street 1:731 CONEY ISLAND AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11218-4288
Practice Address - Country:US
Practice Address - Phone:347-322-2284
Practice Address - Fax:718-693-7770
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-14
Last Update Date:2020-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04019132Medicaid