Provider Demographics
NPI:1528589389
Name:I CARE MEDICAL PLLC
Entity Type:Organization
Organization Name:I CARE MEDICAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPHINE
Authorized Official - Middle Name:O
Authorized Official - Last Name:JUNG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-775-8000
Mailing Address - Street 1:1575 HILLSIDE AVE STE 302
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040-2532
Mailing Address - Country:US
Mailing Address - Phone:516-775-8000
Mailing Address - Fax:516-775-8001
Practice Address - Street 1:1575 HILLSIDE AVE
Practice Address - Street 2:302
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11040-2521
Practice Address - Country:US
Practice Address - Phone:516-775-8000
Practice Address - Fax:516-775-8001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-02
Last Update Date:2021-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY199987208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
199987OtherHIP
10201894OtherEMPIRE BC/BS
P1316150OtherOXFORD
NY017244047Medicaid
132739694Other1199 SEIU
5271770OtherAETNA
1897650OtherUNITED
2696113OtherGHI
3071837OtherAETNA
199987-A31OtherHEALTHFIRST
9444405P01OtherCIGNA