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Organization
QUEENS LONG ISLAND MEDICAL GROUP, P.C.
Active
Organization
QUEENS LONG ISLAND MEDICAL GROUP, P.C.
Active
Other names
AdvantageCare Physicians
Organization subpart
No
Provider details
NPI number
Authorized official
MARLENA SIMPSON (AVP, CREDENTIALING)
(646) 680-2894
Entity
Organization
Contact information
Practice address
441 9TH AVE, 9TH FLOOR, NEW YORK, NY 10001-1623
(646) 680-2894
Mailing address
441 9TH AVE, 9TH FLOOR, NEW YORK, NY 10001-1623
(646) 680-2894
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
—
—
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
207RH0003X
Hematology & Oncology Physician
—
—
207RP1001X
Pulmonary Disease Physician
—
—
207RR0500X
Rheumatology Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
207W00000X
Ophthalmology Physician
—
—
207X00000X
Orthopaedic Surgery Physician
—
—
208000000X
Pediatrics Physician
—
—
2080P0201X
Pediatric Allergy/Immunology Physician
—
—
2080P0205X
Pediatric Endocrinology Physician
—
—
208600000X
Surgery Physician
—
—
208800000X
Urology Physician
—
—
213E00000X
Podiatrist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04007250
—
NY
Enumeration date
05/31/2006
Last updated
06/04/2015
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