South Queens Medical Group PLLC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

231106 Issued in NY

Legal business name

SOUTH QUEENS MEDICAL GROUP PLLC

Practice address

13124 Rockaway Blvd
South Ozone Park, NY 11420-2932

Phone

(718) 659-7166

NPI assigned

Jul 24, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Alfred Abraham, MD

Title

Physician

Phone

(718) 659-7166

Specialties & licenses 4

Addresses

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

{
    "created_epoch": "1343088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1367798400000",
    "number": "1053667394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13124 ROCKAWAY BLVD",
            "city": "SOUTH OZONE PARK",
            "state": "NY",
            "postal_code": "114202932",
            "telephone_number": "718-659-7166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13124 ROCKAWAY BLVD",
            "city": "SOUTH OZONE PARK",
            "state": "NY",
            "postal_code": "114202932",
            "telephone_number": "718-659-7166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH QUEENS MEDICAL GROUP PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-24",
        "last_updated": "2013-05-06",
        "status": "A",
        "authorized_official_last_name": "ABRAHAM",
        "authorized_official_first_name": "ALFRED",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "718-659-7166",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "107354",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "118770",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "231106",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "NY",
            "license": "153485",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel Solomon-Stahler
• Shireese Sookram, RN
• Shirelle Sookram, RN
• South Queens Acupucture, P.C.
• South Queens Imaging P C
• South Queens Pediatric Assoc, LLP
• Tina Souverain, LMSW
• Vera Spektor, MSW
• Sreenidhi Pharma Inc
• Start Where You Stand, Inc.

• Pediatrics Physician in South Ozone Park, NY
• Providers in South Ozone Park, NY by specialty
• Pediatrics Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2013; 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.