Provider Demographics
NPI:1467680751
Name:CROSS COUNTY MEDICAL CARE PC
Entity Type:Organization
Organization Name:CROSS COUNTY MEDICAL CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIE
Authorized Official - Middle Name:ALIXE
Authorized Official - Last Name:BELOTTE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-641-0600
Mailing Address - Street 1:793 N ASCAN ST
Mailing Address - Street 2:
Mailing Address - City:ELMONT
Mailing Address - State:NY
Mailing Address - Zip Code:11003-4621
Mailing Address - Country:US
Mailing Address - Phone:516-641-0600
Mailing Address - Fax:718-347-9100
Practice Address - Street 1:23811 BRADDOCK AVE FL 1
Practice Address - Street 2:
Practice Address - City:BELLEROSE
Practice Address - State:NY
Practice Address - Zip Code:11426-1147
Practice Address - Country:US
Practice Address - Phone:718-354-8300
Practice Address - Fax:718-347-9100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-25
Last Update Date:2011-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY221774207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYH40796Medicare UPIN