Provider Demographics
NPI:1659539781
Name:MEDICAL ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:MEDICAL ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIE
Authorized Official - Middle Name:E
Authorized Official - Last Name:DY-GUILLAUME
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-779-9599
Mailing Address - Street 1:8708 JUSTICE AVE
Mailing Address - Street 2:SUITE CS
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-4575
Mailing Address - Country:US
Mailing Address - Phone:718-779-9599
Mailing Address - Fax:718-779-9579
Practice Address - Street 1:8708 JUSTICE AVE
Practice Address - Street 2:SUITE CS
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-4575
Practice Address - Country:US
Practice Address - Phone:718-779-9599
Practice Address - Fax:718-779-9579
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-27
Last Update Date:2008-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY210261207RG0100X
NY201321207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Multi-Specialty
No207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03028379Medicaid
NY03028379Medicaid