Organization
LOYAL MEDICAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATSUKO TAKESHIGE (PRESIDENT)
(718) 661-4800
Entity
Organization
Contact information
Practice address
4242 COLDEN ST APT L17, FLUSHING, NY 11355-4855
(718) 661-4800
(718) 888-2701
Mailing address
4242 COLDEN ST APT L17, FLUSHING, NY 11355-4855
(718) 661-4800
(718) 888-2701
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
25MB09434100
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0460931
—
NJ
Enumeration date
02/11/2015
Last updated
11/04/2025
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