Provider Demographics
NPI:1336400837
Name:FAMILY HEALTH MEDICAL SERVICES, PC
Entity Type:Organization
Organization Name:FAMILY HEALTH MEDICAL SERVICES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:PIERRE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-525-5505
Mailing Address - Street 1:20003 LINDEN BLVD
Mailing Address - Street 2:
Mailing Address - City:SAINT ALBANS
Mailing Address - State:NY
Mailing Address - Zip Code:11412-3223
Mailing Address - Country:US
Mailing Address - Phone:718-525-5505
Mailing Address - Fax:718-525-8102
Practice Address - Street 1:20003 LINDEN BLVD
Practice Address - Street 2:
Practice Address - City:SAINT ALBANS
Practice Address - State:NY
Practice Address - Zip Code:11412-3223
Practice Address - Country:US
Practice Address - Phone:718-525-5505
Practice Address - Fax:718-525-8102
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-01
Last Update Date:2012-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY189714305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization