Provider Demographics
NPI:1457017261
Name:FUTURE MEDICAL PC
Entity Type:Organization
Organization Name:FUTURE MEDICAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SHOIRAKHON
Authorized Official - Middle Name:
Authorized Official - Last Name:BAKIEVA
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PHD
Authorized Official - Phone:347-249-5873
Mailing Address - Street 1:10205 NORTHERN BLVD
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:NY
Mailing Address - Zip Code:11368-5392
Mailing Address - Country:US
Mailing Address - Phone:347-420-0242
Mailing Address - Fax:347-464-0712
Practice Address - Street 1:10205 NORTHERN BLVD
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:NY
Practice Address - Zip Code:11368-5392
Practice Address - Country:US
Practice Address - Phone:347-420-0242
Practice Address - Fax:347-464-0712
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-16
Last Update Date:2021-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care