Provider Demographics
NPI:1821369125
Name:NEW START FAMILY MEDICAL PC
Entity Type:Organization
Organization Name:NEW START FAMILY MEDICAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:
Authorized Official - Last Name:GRIFFITH-REECE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-712-6886
Mailing Address - Street 1:14524 230TH ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD GARDENS
Mailing Address - State:NY
Mailing Address - Zip Code:11413-3927
Mailing Address - Country:US
Mailing Address - Phone:718-712-6886
Mailing Address - Fax:718-712-2346
Practice Address - Street 1:14524 230TH ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD GARDENS
Practice Address - State:NY
Practice Address - Zip Code:11413-3927
Practice Address - Country:US
Practice Address - Phone:718-712-6886
Practice Address - Fax:718-712-2346
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NEW START FAMILY MEDICAL PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-01-18
Last Update Date:2012-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY163568261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYD47445Medicare PIN
NYD47445Medicare UPIN