Organization
JAMAICA ESTATES FAMILY MEDICAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDGAR Z VANEGAS M.D. (MEDICAL DIRECTOR)
(718) 658-7482
Entity
Organization
Contact information
Practice address
8505 167TH ST, JAMAICA, NY 11432-2621
(718) 658-7482
(718) 658-7531
Mailing address
8505 167TH ST, JAMAICA, NY 11432-2621
(718) 658-7482
(718) 658-7531
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
190283-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02576630
—
NY
Enumeration date
10/16/2006
Last updated
01/30/2013
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