Organization
FOUR CORNERS MEDICAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEAN-YVES DASTAIN MD (OWNER)
(347) 466-3605
Entity
Organization
Contact information
Practice address
11622 METROPOLITAN AVE, RICHMOND HILL, NY 11418-1017
(347) 466-3605
(347) 317-7895
Mailing address
7907 METROPOLITAN AVE, MIDDLE VILLAGE, NY 11379-2930
(347) 466-3605
(347) 317-7895
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
06/12/2022
Last updated
05/21/2025
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