Provider Demographics
NPI:1760657597
Name:WELLCARE PHYSICIAN CONSULTING, PC
Entity Type:Organization
Organization Name:WELLCARE PHYSICIAN CONSULTING, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:SUMEI
Authorized Official - Middle Name:
Authorized Official - Last Name:ZHOU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-672-2824
Mailing Address - Street 1:1226 74TH ST
Mailing Address - Street 2:#1
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11228-2017
Mailing Address - Country:US
Mailing Address - Phone:718-672-2824
Mailing Address - Fax:
Practice Address - Street 1:1226 74TH ST
Practice Address - Street 2:#1
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11228-2017
Practice Address - Country:US
Practice Address - Phone:718-672-2824
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-23
Last Update Date:2008-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY234019207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0650ASMedicare PIN