Provider Demographics
NPI:1568684660
Name:FLUSHING PRIMARY CARE ASSOCIATES, LLP
Entity Type:Organization
Organization Name:FLUSHING PRIMARY CARE ASSOCIATES, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KAVITHA
Authorized Official - Middle Name:D
Authorized Official - Last Name:REDDY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-969-6640
Mailing Address - Street 1:72-18 164TH STREET
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11365-4222
Mailing Address - Country:US
Mailing Address - Phone:718-969-6640
Mailing Address - Fax:718-969-1050
Practice Address - Street 1:72-18 164TH STREET
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11365-4222
Practice Address - Country:US
Practice Address - Phone:718-969-6640
Practice Address - Fax:718-969-1050
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00020Medicare ID - Type Unspecified