East Queens Medical Diagnostic Services, PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

179357 Issued in NY

Legal business name

EAST QUEENS MEDICAL DIAGNOSTIC SERVICES, PC

Practice address

23011 Linden Blvd
Cambria Heights, NY 11411-1851

Phone

(718) 276-3400

Fax

(718) 276-3402

NPI assigned

Nov 16, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Clinton J Sewell, M.D.

Title

President

Phone

(718) 276-3400

Specialties & licenses 2

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1195171200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1195171200000",
    "number": "1003097270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230-11 LINDEN BLVD",
            "city": "CAMBRIA HEIGHTS",
            "state": "NY",
            "postal_code": "114111851",
            "telephone_number": "718-276-3400",
            "fax_number": "718-276-3402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23011 LINDEN BLVD",
            "city": "CAMBRIA HEIGHTS",
            "state": "NY",
            "postal_code": "114111851",
            "telephone_number": "718-276-3400",
            "fax_number": "718-276-3402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST QUEENS MEDICAL DIAGNOSTIC SERVICES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-16",
        "last_updated": "2007-11-16",
        "status": "A",
        "authorized_official_last_name": "SEWELL",
        "authorized_official_first_name": "CLINTON",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-276-3400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "179357",
            "primary": true
        },
        {
            "code": "2085B0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Body Imaging",
            "state": "NY",
            "license": "116260",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Cambria Heights, NY
• Providers in Cambria Heights, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.