# KWEIBA MEDICAL PC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** SPRING FORTH MEDICAL P.C.
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1336980945
- **Legal business name:** SPRING FORTH MEDICAL P.C.
- **Authorized official:** BAABA BLANKSON MD (FOUNDER AND PRESIDENT)
- **Authorized official phone:** (937) 617-1197

## Contact information

- **Practice address:** 7143 SUTTON PL APT 3, FRESH MEADOWS, NY 11365-4584
- **Practice address phone:** (917) 617-1197
- **Mailing address:** 7529 PARSONS BLVD \# 1018, FRESH MEADOWS, NY 11366-1037

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/06/2024
- **Last updated:** 06/06/2024