# FIVE STAR MEDICAL OFFICE PC

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

## Provider details

- **NPI number:** 1760731459
- **Authorized official:** DR. CELESTE DAYE (VP REVENUE MANAGEMENT)
- **Authorized official phone:** (470) 553-3591

## Contact information

- **Practice address:** 10407 METROPOLITAN AVE, FOREST HILLS, NY 11375-6735
- **Practice address phone:** (718) 576-4652
- **Practice address fax:** (516) 710-7846
- **Mailing address:** PO BOX 801280, KANSAS CITY, MO 64180-1280
- **Mailing address phone:** (718) 576-4652
- **Mailing address fax:** (516) 710-7846

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | 265676 | NY | — |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 09/10/2012
- **Last updated:** 03/15/2023