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Organization
QUEENS BRONX MEDICAL P.C
Active
Organization
QUEENS BRONX MEDICAL P.C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VIJAY K ALLA M.D (PRESIDENT)
(718) 274-6100
Entity
Organization
Contact information
Practice address
4102 31ST AVE, ASTORIA, NY 11103-3420
(718) 274-6100
(718) 665-1746
Mailing address
4102 31ST AVE, ASTORIA, NY 11103-3420
(718) 274-6100
(718) 665-1746
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
211067
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00006049401
FIDELIS
NY
05
—
01914447
—
NY
01
—
06864
NY GHI MEDICARE
NY
01
—
06864G
GHI MEDICARE CHOICE
NY
01
—
1000003667
AFFINITY HEALTH PLAN
NY
01
—
171389
ELDERPLAN
NY
01
—
1P1158
HEALTHNET
NY
01
—
211067
HIP
NY
01
—
211067C19
HEALTHFIRST
NY
01
—
2511884
GHI
NY
01
—
AV1067
ATLANTIS
NY
01
—
VA0184AK10
EMPIRE BLUE CROSS
NY
Enumeration date
05/23/2007
Last updated
04/20/2008
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