Provider Demographics
NPI:1740272814
Name:QUEENS NEPHROLOGY ASSOCIATES
Entity type:Organization
Organization Name:QUEENS NEPHROLOGY ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NEPHROLOGY
Authorized Official - Prefix:MRS
Authorized Official - First Name:EVELYN
Authorized Official - Middle Name:RUZOL
Authorized Official - Last Name:AMARGA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-651-9700
Mailing Address - Street 1:3435 70TH ST
Mailing Address - Street 2:
Mailing Address - City:JACKSON HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11372-1055
Mailing Address - Country:US
Mailing Address - Phone:718-651-9700
Mailing Address - Fax:718-533-0264
Practice Address - Street 1:3435 70TH ST
Practice Address - Street 2:
Practice Address - City:JACKSON HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11372-1055
Practice Address - Country:US
Practice Address - Phone:718-651-9700
Practice Address - Fax:718-533-0264
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty