Titan Primary Care, Inc

Primary specialty

Addiction Medicine (Family Medicine) PhysicianTaxonomy code 207QA0401X

Legal business name

TITAN PRIMARY CARE, INC

Practice address

3753 90TH St Ste 11
Jackson Heights, NY 11372-7879

Phone

(623) 738-6372

NPI assigned

Aug 5, 2020

Organization subpart

No

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

Authorized official

Name

Pablo Esteban Bustos

Title

Ceo

Phone

(623) 738-6372

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1596585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1596585600000",
    "number": "1053921957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3753 90TH ST STE 11",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "113727879",
            "telephone_number": "623-738-6372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3753 90TH ST STE 11",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "113727879",
            "telephone_number": "623-738-6372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TITAN PRIMARY CARE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-05",
        "last_updated": "2020-08-05",
        "certification_date": "2020-08-05",
        "status": "A",
        "authorized_official_last_name": "BUSTOS",
        "authorized_official_first_name": "PABLO",
        "authorized_official_middle_name": "ESTEBAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "623-738-6372"
    },
    "taxonomies": [
        {
            "code": "207QA0401X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Addiction Medicine (Family Medicine) Physician in Jackson Heights, NY
• Providers in Jackson Heights, NY by specialty
• Addiction Medicine (Family Medicine) Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2020; 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.