Provider Demographics
NPI:1356521298
Name:PROMPT CARE INC
Entity type:Organization
Organization Name:PROMPT CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KHALED
Authorized Official - Middle Name:OMAR
Authorized Official - Last Name:ELBANNA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-706-8060
Mailing Address - Street 1:2543 STEINWAY ST
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11103-3701
Mailing Address - Country:US
Mailing Address - Phone:718-706-8060
Mailing Address - Fax:718-706-8650
Practice Address - Street 1:2543 STEINWAY ST
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11103-3701
Practice Address - Country:US
Practice Address - Phone:718-706-8060
Practice Address - Fax:718-706-8650
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-08
Last Update Date:2007-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY224801261QH0100X, 261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYH93578Medicare UPIN