Organization
TITAN PRIMARY CARE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PABLO ESTEBAN BUSTOS (CEO)
(623) 738-6372
Entity
Organization
Contact information
Practice address
3753 90TH ST STE 11, JACKSON HEIGHTS, NY 11372-7879
(623) 738-6372
Mailing address
3753 90TH ST STE 11, JACKSON HEIGHTS, NY 11372-7879
(623) 738-6372
Taxonomy
Speciality
Code
Description
License number
State
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
—
—
Other
Enumeration date
08/05/2020
Last updated
08/05/2020
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