Provider Demographics
NPI:1588854541
Name:QUALITY CARE MEDICAL OF NY PC
Entity Type:Organization
Organization Name:QUALITY CARE MEDICAL OF NY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:HARD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-544-1444
Mailing Address - Street 1:15031 UNION TPKE
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11367-3927
Mailing Address - Country:US
Mailing Address - Phone:718-544-1444
Mailing Address - Fax:718-969-1595
Practice Address - Street 1:15031 UNION TPKE
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11367-3927
Practice Address - Country:US
Practice Address - Phone:718-544-1444
Practice Address - Fax:718-969-1595
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-26
Last Update Date:2007-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY05331Medicare PIN