Organization
COMPLETE CARE MEDICAL OF N.Y. P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARIANO MEDEROS M.D. (M.D.)
(718) 894-2500
Entity
Organization
Contact information
Practice address
311 SAINT NICHOLAS AVE STE E, RIDGEWOOD, NY 11385-2296
(718) 894-2500
(718) 417-4535
Mailing address
311 SAINT NICHOLAS AVE STE E, RIDGEWOOD, NY 11385-2296
(718) 894-2500
(718) 417-4535
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00947791
—
NY
Enumeration date
12/03/2010
Last updated
06/06/2016
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