Organization
PREMIUM MEDICAL OF NY,PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHRISTOPHER GEORGIOU MD (PRESIDENT)
(718) 445-1223
Entity
Organization
Contact information
Practice address
14709 ELM AVE, SUITE B1, FLUSHING, NY 11355-1705
(718) 445-1223
(718) 445-1539
Mailing address
14709 ELM AVE, SUITE B1, FLUSHING, NY 11355-1705
(718) 445-1223
(718) 445-1539
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
193788
NY
207RN0300X
Nephrology Physician
Primary
193788
NY
Other
Enumeration date
04/06/2012
Last updated
04/06/2012
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