Organization
EAST ELMHURST PRIMARY MEDICAL CARE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ERIC JONES (CREDENTIALING SPECIALIST)
(718) 233-9122
Entity
Organization
Contact information
Practice address
2008 SEAGIRT BLVD, FAR ROCKAWAY, NY 11691-2803
(718) 565-6880
(877) 796-4457
Mailing address
2008 SEAGIRT BLVD, FAR ROCKAWAY, NY 11691-2803
(718) 565-6880
(877) 796-4457
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
180270
NY
207RS0012X
Sleep Medicine (Internal Medicine) Physician
Primary
180270
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01454842
—
NY
01
—
180270
NYS MEDICAL LIC #
NY
Enumeration date
05/26/2006
Last updated
07/02/2024
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