Provider Demographics
NPI:1265197123
Name:JAMAICA HEALTHY MEDICAL PC
Entity type:Organization
Organization Name:JAMAICA HEALTHY MEDICAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:J
Authorized Official - Last Name:GIBBS
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:212-867-0405
Mailing Address - Street 1:PO BOX 640458
Mailing Address - Street 2:
Mailing Address - City:OAKLAND GARDENS
Mailing Address - State:NY
Mailing Address - Zip Code:11364
Mailing Address - Country:US
Mailing Address - Phone:929-336-7603
Mailing Address - Fax:929-336-7608
Practice Address - Street 1:12 EAST 44TH STREET
Practice Address - Street 2:6TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017
Practice Address - Country:US
Practice Address - Phone:212-867-0405
Practice Address - Fax:212-867-0409
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-05
Last Update Date:2021-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty