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Organization
PHOENIX RISES MEDICAL SERVICES, P.C.
Active
Organization
PHOENIX RISES MEDICAL SERVICES, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TOMAS PATTUGALAN MD (PRESIDENT/OWNER)
(718) 736-5749
Entity
Organization
Contact information
Practice address
17541 HILLSIDE AVE, JAMAICA, NY 11432-5724
(718) 298-9500
(718) 658-0306
Mailing address
17541 HILLSIDE AVE, JAMAICA, NY 11432-5724
(718) 298-9500
(718) 658-0306
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00726912
—
NY
Enumeration date
08/13/2019
Last updated
08/13/2019
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