Provider Demographics
NPI:1275684458
Name:METRO HEALTH MEDICAL P.C.
Entity Type:Organization
Organization Name:METRO HEALTH MEDICAL P.C.
Other - Org Name:METRO MED
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:M
Authorized Official - Last Name:FELDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-380-6002
Mailing Address - Street 1:79-18 164TH STREET
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11432-1115
Mailing Address - Country:US
Mailing Address - Phone:718-380-6002
Mailing Address - Fax:718-380-6148
Practice Address - Street 1:79-18 164TH STREET
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11432-1115
Practice Address - Country:US
Practice Address - Phone:718-380-6002
Practice Address - Fax:718-380-6148
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-15
Last Update Date:2009-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY179239-3174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty