NPIMap

Organization Active NPI

Ez Medhealth Care PC

  • Multi-Specialty Clinic/Center
  • Forest Hills, NY
National Provider Identifier
1245347301
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
EZ MEDHEALTH CARE PC
Practice address
101-20 Queens Blvd
Ez Medhealth Care PC
Forest Hills, NY 11375
Phone
(718) 730-0100
Fax
(718) 730-9439
NPI assigned
Aug 24, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Vadim Davydov, DONPI 1538264346
Title
Medical Director
Phone
(718) 730-0100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

101-20 Queens Blvd
Ez Medhealth Care PC
Forest Hills, NY 11375

Mailing address

101- 20 Queens Blvd
Ez Medhealth Care PC
Forest Hills, NY 11375
Phone (718) 730-0100

Other identifiers 1

IdentifierTypeStateIssuer
02632364MedicaidNY

National Provider Directory

National Provider Directory

Locations

10120 Queens Blvd
Forest Hills, NY 11375
Phone (718) 730-0100

Practitioners & affiliated clinicians

Practitioners 20

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1245347301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101- 20 QUEENS BLVD",
            "address_2": "EZ MEDHEALTH CARE PC",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "11375",
            "telephone_number": "718-730-0100",
            "fax_number": "718-730-9439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101-20 QUEENS BLVD",
            "address_2": "EZ MEDHEALTH CARE PC",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "11375",
            "telephone_number": "718-730-0100",
            "fax_number": "718-730-9439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EZ MEDHEALTH CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DAVYDOV",
        "authorized_official_first_name": "VADIM",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "718-730-0100",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02632364",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hills, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.