Provider Demographics
NPI:1750755088
Name:METROPLEX MEDICAL CARE PC
Entity type:Organization
Organization Name:METROPLEX MEDICAL CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:EDOUARD
Authorized Official - Middle Name:M
Authorized Official - Last Name:BELOTTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-835-6755
Mailing Address - Street 1:23807 BRADDOCK AVE
Mailing Address - Street 2:
Mailing Address - City:BELLEROSE
Mailing Address - State:NY
Mailing Address - Zip Code:11426-1147
Mailing Address - Country:US
Mailing Address - Phone:718-354-8300
Mailing Address - Fax:718-347-9100
Practice Address - Street 1:23807 BRADDOCK AVE
Practice Address - Street 2:
Practice Address - City:BELLEROSE
Practice Address - State:NY
Practice Address - Zip Code:11426-1147
Practice Address - Country:US
Practice Address - Phone:718-354-8300
Practice Address - Fax:718-347-9100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-24
Last Update Date:2015-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY221380207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY221380OtherSTATE LICENSE