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Organization
SOUTH QUEENS MEDICAL GROUP PLLC
Active
Organization
SOUTH QUEENS MEDICAL GROUP PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALFRED ABRAHAM MD (PHYSICIAN)
(718) 659-7166
Entity
Organization
Contact information
Practice address
13124 ROCKAWAY BLVD, SOUTH OZONE PARK, NY 11420-2932
(718) 659-7166
Mailing address
13124 ROCKAWAY BLVD, SOUTH OZONE PARK, NY 11420-2932
(718) 659-7166
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
107354
NY
207R00000X
Internal Medicine Physician
118770
NY
208000000X
Pediatrics Physician
Primary
231106
NY
208600000X
Surgery Physician
153485
NY
Other
Enumeration date
07/24/2012
Last updated
05/06/2013
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