96TH STREET JUNCTION BLVD MEDICAL PC

CORONA, NY
NPI1588157788
Entity TypeOrganization
Authorized ContactWILDER RUCKER
Owner
718-606-1199
Organization Subpart ?No
Primary Taxonomy207Q00000X Family Medicine
Enumeration Date2018-06-12
Last Update Date2018-08-13
Business Address
96TH STREET JUNCTION BLVD MEDICAL PC
5548 96TH ST
CORONA, NY 11368
Phone number: 718-606-1199
Mailing Address
96TH STREET JUNCTION BLVD MEDICAL PC
5548 96TH ST
CORONA, NY 11368-3009
Phone number:
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