Organization
QUEENS VILLAGE PRIMARY MEDICAL CARE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ARYEL NICOLEAU MD (MEDICAL DOCTOR)
(718) 465-3040
Entity
Organization
Contact information
Practice address
9204 SPRINGFIELD BLVD, QUEENS VILLAGE, NY 11428-1857
(718) 465-3040
(718) 464-9063
Mailing address
9204 SPRINGFIELD BLVD, QUEENS VILLAGE, NY 11428-1857
(718) 465-3040
(718) 464-9063
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
141741
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00587146
—
NY
Enumeration date
08/09/2007
Last updated
02/01/2017
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