# UNIVERSAL MEDICAL PRACTICE PC

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

## Provider details

- **NPI number:** 1760533376
- **Authorized official:** DR. NIDIA ROSA CARRERO MD (PRESIDENT)
- **Authorized official phone:** (718) 672-1100

## Contact information

- **Practice address:** 11034 70TH RD, FOREST HILLS, NY 11375-3934
- **Practice address phone:** (718) 672-1100
- **Practice address fax:** (718) 672-7770
- **Mailing address:** PO BOX 270, MASSAPEQUA PARK, NY 11762-0270
- **Mailing address phone:** (631) 264-2035
- **Mailing address fax:** (631) 264-1418

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | 212687 | NY | Yes |

## Other

- **Enumeration date:** 01/12/2007
- **Last updated:** 05/06/2009