Provider Demographics
NPI:1528372893
Name:NORTH SHORE QUEENS MEDICAL ASSOCIATES PLLC
Entity Type:Organization
Organization Name:NORTH SHORE QUEENS MEDICAL ASSOCIATES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GENGHUI
Authorized Official - Middle Name:
Authorized Official - Last Name:ZHU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:877-216-2919
Mailing Address - Street 1:34 CARRIAGE RD
Mailing Address - Street 2:
Mailing Address - City:ROSLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11576-3118
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:14022 BEECH AVE STE 2C
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-2821
Practice Address - Country:US
Practice Address - Phone:877-216-2916
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-29
Last Update Date:2010-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY249189261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care