Provider Demographics
NPI:1194355586
Name:UNITED MEDICAL PRACTICE, P.C.
Entity type:Organization
Organization Name:UNITED MEDICAL PRACTICE, P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:ZENAIDA
Authorized Official - Middle Name:ESPINO
Authorized Official - Last Name:SANTOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-565-0444
Mailing Address - Street 1:7704 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-1927
Mailing Address - Country:US
Mailing Address - Phone:718-565-3144
Mailing Address - Fax:718-639-6409
Practice Address - Street 1:17933 90TH AVE
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11432-4763
Practice Address - Country:US
Practice Address - Phone:718-657-2706
Practice Address - Fax:718-657-2420
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-24
Last Update Date:2020-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty