Provider Demographics
NPI:1760850994
Name:MINOR SURGICAL CENTER
Entity Type:Organization
Organization Name:MINOR SURGICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN
Authorized Official - Prefix:DR
Authorized Official - First Name:RABEYA
Authorized Official - Middle Name:SULTANA
Authorized Official - Last Name:CHOWDHURY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-412-0053
Mailing Address - Street 1:6438 FITCHETT ST
Mailing Address - Street 2:
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-5049
Mailing Address - Country:US
Mailing Address - Phone:718-206-2688
Mailing Address - Fax:718-206-2687
Practice Address - Street 1:9112 175TH ST APT 1A
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11432-5559
Practice Address - Country:US
Practice Address - Phone:718-206-2688
Practice Address - Fax:718-206-2687
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-03
Last Update Date:2015-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY242785174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty