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Organization

STANFORD MEDICAL P.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ELAINE LIU (MANAGER)
(718) 961-8823
Entity
Organization

Contact information

Practice address
13618 39TH AVE # 905, FLUSHING, NY 11354-5400
(718) 961-8823
Mailing address
13618 39TH AVE # 905, FLUSHING, NY 11354-5400

Taxonomy

Speciality
Code
Description
License number
State
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
Primary
130031
NY

Other

Enumeration date
02/23/2012
Last updated
02/23/2012
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