Provider Demographics
NPI:1821363714
Name:FLATLANDS MEDICAL AND URGENT CARE P.C.
Entity Type:Organization
Organization Name:FLATLANDS MEDICAL AND URGENT CARE P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JACQUELIN
Authorized Official - Middle Name:ANTOINE
Authorized Official - Last Name:BELAMY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-927-1355
Mailing Address - Street 1:9613 FLATLANDS AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11236-3711
Mailing Address - Country:US
Mailing Address - Phone:718-927-1355
Mailing Address - Fax:718-927-1360
Practice Address - Street 1:9613 FLATLANDS AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11236-3711
Practice Address - Country:US
Practice Address - Phone:718-927-1355
Practice Address - Fax:718-927-1360
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-12
Last Update Date:2012-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY204828207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
H20778Medicare UPIN