Basic Information
| Provider Information | |||||||||
| NPI: | 1740792233 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | NEW YORK QUEENS MEDICINE AND SURGERY, P.C. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2649 STRANG BLVD STE 304 | ||||||||
| Address2: | |||||||||
| City: | YORKTOWN HEIGHTS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 105982938 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2679798095 | ||||||||
| FaxNumber: | 6466977865 | ||||||||
| Practice Location | |||||||||
| Address1: | 5645 MAIN ST | ||||||||
| Address2: | |||||||||
| City: | FLUSHING | ||||||||
| State: | NY | ||||||||
| PostalCode: | 113555045 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7186618706 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/25/2017 | ||||||||
| LastUpdateDate: | 11/04/2021 | ||||||||
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| AuthorizedOfficialLastName: | RIMAR | ||||||||
| AuthorizedOfficialFirstName: | STEPHEN | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 7186701549 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 11/04/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QM1300X | Y | Ambulatory Health Care Facilities | Clinic/Center | Multi-Specialty |
No ID Information.