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Organization
QUEENS MEDICAL OF NEW YORK LLC
Active
Organization
QUEENS MEDICAL OF NEW YORK LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FLORA KATSNELSON MD (OWNER)
(718) 301-1100
Entity
Organization
Contact information
Practice address
11602 QUEENS BLVD, FOREST HILLS, NY 11375-7055
(718) 301-1100
(888) 621-3330
Mailing address
PO BOX 32, NORTHBROOK, IL 60065-0032
(718) 301-1100
(888) 621-3330
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
NULL
207R00000X
Internal Medicine Physician
—
—
2085R0204X
Vascular & Interventional Radiology Physician
—
NULL
2085R0204X
Vascular & Interventional Radiology Physician
—
—
2086S0129X
Vascular Surgery Physician
Primary
—
NULL
2086S0129X
Vascular Surgery Physician
Primary
—
—
Other
Enumeration date
09/17/2012
Last updated
09/17/2012
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