Provider Demographics
NPI:1295330314
Name:SUNNYSIDE MEDICAL PRACTICE PC
Entity type:Organization
Organization Name:SUNNYSIDE MEDICAL PRACTICE PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:FELIX
Authorized Official - Middle Name:
Authorized Official - Last Name:FLORIMON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-781-0051
Mailing Address - Street 1:PO BOX 774
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10033-0595
Mailing Address - Country:US
Mailing Address - Phone:212-781-0051
Mailing Address - Fax:
Practice Address - Street 1:4710 GREENPOINT AVE
Practice Address - Street 2:
Practice Address - City:SUNNYSIDE
Practice Address - State:NY
Practice Address - Zip Code:11104-1710
Practice Address - Country:US
Practice Address - Phone:718-383-0830
Practice Address - Fax:718-685-2489
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FELIX FLORIMON, MD
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-12-04
Last Update Date:2020-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty