Provider Demographics
NPI:1528183480
Name:QUEENS ENDOCRINOLOGY PARTNERS
Entity type:Organization
Organization Name:QUEENS ENDOCRINOLOGY PARTNERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:INGRID
Authorized Official - Middle Name:IVANNA
Authorized Official - Last Name:FELIX-PERALTA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-334-6712
Mailing Address - Street 1:9320 ROOSEVELT AVE # A
Mailing Address - Street 2:2ND FL
Mailing Address - City:JACKSON HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11372-7904
Mailing Address - Country:US
Mailing Address - Phone:718-334-6712
Mailing Address - Fax:
Practice Address - Street 1:9320 ROOSEVELT AVE # A
Practice Address - Street 2:2ND FL
Practice Address - City:JACKSON HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11372-7904
Practice Address - Country:US
Practice Address - Phone:718-334-6712
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2007-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080P0205XAllopathic & Osteopathic PhysiciansPediatricsPediatric EndocrinologyGroup - Single Specialty