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Organization
TRI-BOROUGH NY MEDICAL PRACTICE PC
Active
Organization
TRI-BOROUGH NY MEDICAL PRACTICE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS NEESHA N MOHAMMED (PRACTICE MANAGER)
(855) 699-7246
Entity
Organization
Contact information
Practice address
9016 SUTPHIN BLVD, JAMAICA, NY 11435-3636
(719) 487-4016
Mailing address
185 KINGSLAND ST, NUTLEY, NJ 07110-1119
(855) 699-7246
(718) 766-9763
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
NULL
174400000X
Specialist
—
—
207L00000X
Anesthesiology Physician
—
NULL
207L00000X
Anesthesiology Physician
—
—
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
NULL
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
NULL
207R00000X
Internal Medicine Physician
—
—
207X00000X
Orthopaedic Surgery Physician
—
NULL
207X00000X
Orthopaedic Surgery Physician
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
NULL
208100000X
Physical Medicine & Rehabilitation Physician
—
—
208VP0014X
Interventional Pain Medicine Physician
—
NULL
208VP0014X
Interventional Pain Medicine Physician
—
—
363AS0400X
Surgical Physician Assistant
—
NULL
363AS0400X
Surgical Physician Assistant
—
—
Other
Enumeration date
05/04/2021
Last updated
05/04/2021
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