Organization
COLUMBUS CIRCLE MEDICAL SERVICES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PRABASH KONERU MD (CEO)
(347) 276-8866
Entity
Organization
Contact information
Practice address
17121 JAMAICA AVE, JAMAICA, NY 11432-5427
(718) 521-4442
(718) 305-4568
Mailing address
2114 PACIFIC BLVD, ATLANTIC BEACH, NY 11509-1139
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
250331
NY
Other
Enumeration date
06/05/2017
Last updated
01/29/2020
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