Organization
BENEMED PHYSICIAN, PC
Active
Other names
Latina Medica, PC
Organization subpart
No
Provider details
NPI number
Authorized official
KIM MOI WONG LAMA MD (PRESIDENT)
(347) 808-8325
Entity
Organization
Contact information
Practice address
10119 39TH AVE, SUITE # 101, CORONA, NY 11368-4806
(347) 808-8325
(347) 808-8326
Mailing address
10119 39TH AVE, SUITE # 101, CORONA, NY 11368-4806
(347) 808-8325
(347) 808-8326
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
258195
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
258195
NYS LICENSE NUMBER
NY
Enumeration date
01/03/2012
Last updated
06/11/2012
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