# JACKSON HEIGHTS MEDICAL CARE PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003250762
- **Authorized official:** CARL A. NICHOLEAU (OWNER)
- **Authorized official phone:** (718) 344-5293

## Contact information

- **Practice address:** 2008 SEAGIRT BLVD, FAR ROCKAWAY, NY 11691-2803
- **Practice address phone:** (718) 565-6880
- **Practice address fax:** (877) 796-4457
- **Mailing address:** 7535 31ST AVE, SUITE 200, EAST ELMHURST, NY 11370-1857
- **Mailing address phone:** (718) 565-6880
- **Mailing address fax:** (718) 565-3102

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RS0012X | Sleep Medicine (Internal Medicine) Physician | — | NULL | Yes |
| 207RS0012X | Sleep Medicine (Internal Medicine) Physician | — | — | Yes |
| 225100000X | Physical Therapist | — | NULL | — |
| 225100000X | Physical Therapist | — | — | — |

## Other

- **Enumeration date:** 04/24/2013
- **Last updated:** 08/26/2024