Provider Demographics
NPI:1609151950
Name:COREHEALTH MEDICAL CARE PLLC
Entity Type:Organization
Organization Name:COREHEALTH MEDICAL CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:CHIKEZIE
Authorized Official - Last Name:IDEYI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-343-2045
Mailing Address - Street 1:24739 JAMAICA
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:BELLEROSE
Mailing Address - State:NY
Mailing Address - Zip Code:11426-1541
Mailing Address - Country:US
Mailing Address - Phone:718-343-2045
Mailing Address - Fax:718-343-2088
Practice Address - Street 1:247-39 JAMAICA AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:QUEENS
Practice Address - State:NY
Practice Address - Zip Code:11426-1541
Practice Address - Country:US
Practice Address - Phone:718-343-2045
Practice Address - Fax:718-343-2088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-19
Last Update Date:2013-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional RadiologyGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty