# QUEENS MEDICAL PAVILION,LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** NY MED
- **Organization subpart:** No

## Provider details

- **NPI number:** 1124384136
- **Authorized official:** MS. ERICA VAZQUEZ (MANAGER)
- **Authorized official phone:** (718) 263-3500

## Contact information

- **Practice address:** 6915 AUSTIN ST, FOREST HILLS, NY 11375-4255
- **Practice address phone:** (718) 263-3500
- **Mailing address:** 69-15 AUSTIN ST, FOREST HILLS, NY 11375
- **Mailing address phone:** (718) 263-3500

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | — | — | — |
| 204C00000X | Sports Medicine (Neuromusculoskeletal Medicine) Physician | — | — | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |
| 208VP0014X | Interventional Pain Medicine Physician | — | — | — |
| 225100000X | Physical Therapist | — | — | — |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 04/03/2012
- **Last updated:** 01/15/2026