Provider Demographics
NPI:1104263128
Name:ADVANTAGE HEALTH MEDICAL PC
Entity type:Organization
Organization Name:ADVANTAGE HEALTH MEDICAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:YUQING
Authorized Official - Middle Name:
Authorized Official - Last Name:ZHANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-909-7041
Mailing Address - Street 1:14147 NORTHERN BLVD
Mailing Address - Street 2:FLOOR 3
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-4238
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:14147 NORTHERN BLVD
Practice Address - Street 2:FLOOR 3
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-4238
Practice Address - Country:US
Practice Address - Phone:347-909-7041
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-31
Last Update Date:2013-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY260295207U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207U00000XAllopathic & Osteopathic PhysiciansNuclear MedicineGroup - Multi-Specialty