Organization
SSS FAMILY MEDICINE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SOPHIA STREETE-SMALLS MD (PRESIDENT)
(917) 693-6687
Entity
Organization
Contact information
Practice address
11513A MERRICK BLVD, JAMAICA, NY 11434-1851
(718) 558-8998
(718) 558-8999
Mailing address
11513A MERRICK BLVD, JAMAICA, NY 11434-1851
(718) 558-8998
(718) 558-8999
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
218731
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02180096
—
NY
Enumeration date
03/10/2010
Last updated
03/10/2010
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