Provider Demographics
NPI:1932188869
Name:QUEENS MEDICAL ASSOCIATES PC
Entity Type:Organization
Organization Name:QUEENS MEDICAL ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:H
Authorized Official - Last Name:KAPLAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-460-2300
Mailing Address - Street 1:176-60 UNION TPKE
Mailing Address - Street 2:SUITE 360
Mailing Address - City:FRESH MEADOWS
Mailing Address - State:NY
Mailing Address - Zip Code:11366-1531
Mailing Address - Country:US
Mailing Address - Phone:718-460-2300
Mailing Address - Fax:347-225-9930
Practice Address - Street 1:176-60 UNION TPKE
Practice Address - Street 2:SUITE 360
Practice Address - City:FRESH MEADOWS
Practice Address - State:NY
Practice Address - Zip Code:11366
Practice Address - Country:US
Practice Address - Phone:718-460-2300
Practice Address - Fax:718-225-9930
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-10
Last Update Date:2018-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY098442-1174400000X
NY205686-1174400000X
NY184568-1174400000X
NY214868-1174400000X
NY098442207RH0003X
NY232226208VP0000X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Multi-Specialty
No174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Multi-Specialty
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01523413Medicaid
NY02277943Medicaid
NY00167753Medicaid
NY01878019Medicaid
NY02168692Medicaid
NY4529170001Medicare NSC
NYA64797Medicare UPIN
NY04356LMedicare ID - Type UnspecifiedWEI
NY01523413Medicaid
NY01878019Medicaid
NY00167753Medicaid
NY02168692Medicaid
NYH59618Medicare UPIN
NYF84840Medicare UPIN
NY04356JMedicare ID - Type UnspecifiedFULMAN