PROVISION AT NEW YORK LLC

REGO PARK, NY
NPI1467749630
Entity TypeOrganization
Authorized ContactEMILY Y CHU
CEO
718-780-7862
Organization Subpart ?No
Primary Taxonomy261Q00000X Clinic/Center
(Licence: NY  TUV006676)
Additional Taxonomies261QP2300X Clinic/Center, Primary Care
(Licence: NY  TUV006676)
Enumeration Date2011-07-07
Last Update Date2012-07-31
Business Address
PROVISION AT NEW YORK LLC
6135 JUNCTION BLVD
REGO PARK, NY 11374-2771
Phone number: 718-760-7862
Mailing Address
PROVISION AT NEW YORK LLC
7285 YELLOWSTONE BLVD
FOREST HILLS, NY 11375-4133
Phone number: 718-760-7862