Provider Demographics
NPI:1598084709
Name:GOOD CARE MEDICAL,P.C.
Entity Type:Organization
Organization Name:GOOD CARE MEDICAL,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JING
Authorized Official - Middle Name:
Authorized Official - Last Name:DENG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-888-7122
Mailing Address - Street 1:4233 KISSENA BLVD
Mailing Address - Street 2:1A
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-3241
Mailing Address - Country:US
Mailing Address - Phone:718-888-7122
Mailing Address - Fax:718-888-7172
Practice Address - Street 1:4233 KISSENA BLVD
Practice Address - Street 2:1A
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-3241
Practice Address - Country:US
Practice Address - Phone:718-888-7122
Practice Address - Fax:718-888-7172
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-27
Last Update Date:2010-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY212380174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02173628Medicaid
NYG96215Medicare UPIN