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Organization

QUEENS MEDICAL PAVILION,LLC

Active
Other names
NY MED
Organization subpart
No

Provider details

NPI number
Authorized official
MS. ERICA VAZQUEZ (MANAGER)
(718) 263-3500
Entity
Organization

Contact information

Practice address
6915 AUSTIN ST, FOREST HILLS, NY 11375-4255
(718) 263-3500
Mailing address
69-15 AUSTIN ST, FOREST HILLS, NY 11375
(718) 263-3500

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
204C00000X
Sports Medicine (Neuromusculoskeletal Medicine) Physician
207R00000X
Internal Medicine Physician
208100000X
Physical Medicine & Rehabilitation Physician
Primary
208VP0014X
Interventional Pain Medicine Physician
225100000X
Physical Therapist
261QM1300X
Multi-Specialty Clinic/Center
Primary

Other

Enumeration date
04/03/2012
Last updated
01/15/2026
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