# STANFORD MEDICAL P.C.

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

## Provider details

- **NPI number:** 1245504190
- **Authorized official:** ELAINE LIU (MANAGER)
- **Authorized official phone:** (718) 961-8823

## Contact information

- **Practice address:** 13618 39TH AVE \# 905, FLUSHING, NY 11354-5400
- **Practice address phone:** (718) 961-8823
- **Mailing address:** 13618 39TH AVE \# 905, FLUSHING, NY 11354-5400

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR0401X | Comprehensive Outpatient Rehabilitation Facility (CORF) | 130031 | NY | Yes |

## Other

- **Enumeration date:** 02/23/2012
- **Last updated:** 02/23/2012