Provider Demographics
NPI:1740583764
Name:METROPLUS HEALTH PLAN
Entity Type:Organization
Organization Name:METROPLUS HEALTH PLAN
Other - Org Name:SMART MEDICAL CARE PC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHAMIM
Authorized Official - Middle Name:
Authorized Official - Last Name:BEGUM
Authorized Official - Suffix:
Authorized Official - Credentials:MD,FACP
Authorized Official - Phone:718-526-6660
Mailing Address - Street 1:17545 88TH AVE
Mailing Address - Street 2:APT # 5B
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11432-5759
Mailing Address - Country:US
Mailing Address - Phone:347-484-6653
Mailing Address - Fax:
Practice Address - Street 1:17545 88TH AVE
Practice Address - Street 2:APT # 5B
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11432-5759
Practice Address - Country:US
Practice Address - Phone:347-484-6653
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-14
Last Update Date:2010-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYPX35342RMedicaid