Provider Demographics
NPI:1609254242
Name:STAT MEDICAL SERVICES OF NY PLLC
Entity Type:Organization
Organization Name:STAT MEDICAL SERVICES OF NY PLLC
Other - Org Name:HEALTHNEED MEDICAL URGENT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JACKSON
Authorized Official - Middle Name:H
Authorized Official - Last Name:KUAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-358-3535
Mailing Address - Street 1:13617 39TH AVE STE 1A
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-5504
Mailing Address - Country:US
Mailing Address - Phone:718-888-1808
Mailing Address - Fax:833-888-1808
Practice Address - Street 1:13617 39TH AVE STE 1A
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-5504
Practice Address - Country:US
Practice Address - Phone:718-888-1808
Practice Address - Fax:833-888-1808
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-15
Last Update Date:2019-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1841395100207R00000X
261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty