Active NPI
MMJ Ny Consulting LLC
- Primary Care Clinic/Center
- Flushing, NY
National Provider Identifier
1184331308
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Primary Care Clinic/Center
- Legal business name
- MMJ NY CONSULTING LLC
- Practice address
- 13630 Maple Ave Ste 2B
Flushing, NY 11355-3867 - Phone
- (718) 799-0958
- Fax
- (718) 799-0959
- NPI assigned
- Oct 28, 2022
- Last updated
- Oct 28, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Linke Ma, DO
- Title
- Physician
- Phone
- (347) 417-2563
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Clinic/Center | 261QP2300X | NU | Primary |
Addresses
Primary practice location
13630 Maple Ave Ste 2B
Flushing, NY 11355-3867
Mailing address
13630 Maple Ave Ste 2B
Flushing, NY 11355-3867
Phone (718) 799-0958
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932553427 | Medicaid | NY |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Family Medicine Physician
- Flushing, NY
- NPI 1932553427
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1666915200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1666915200000",
"number": "1184331308",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13630 MAPLE AVE STE 2B",
"city": "FLUSHING",
"state": "NY",
"postal_code": "113553867",
"telephone_number": "718-799-0958",
"fax_number": "718-799-0959"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13630 MAPLE AVE STE 2B",
"city": "FLUSHING",
"state": "NY",
"postal_code": "113553867",
"telephone_number": "718-799-0958",
"fax_number": "718-799-0959"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MMJ NY CONSULTING LLC",
"organizational_subpart": "NO",
"enumeration_date": "2022-10-28",
"last_updated": "2022-10-28",
"certification_date": "2022-10-28",
"status": "A",
"authorized_official_last_name": "MA",
"authorized_official_first_name": "LINKE",
"authorized_official_title_or_position": "PHYSICIAN",
"authorized_official_telephone_number": "347-417-2563",
"authorized_official_credential": "DO"
},
"taxonomies": [
{
"code": "261QP2300X",
"taxonomy_group": "",
"desc": "Clinic/Center, Primary Care",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1932553427",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Flushing, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.