410 Medical, P.C

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A188292-1 Issued in NY

Legal business name

410 MEDICAL, P.C

Practice address

9050 Parsons Blvd Ste 410
Jamaica, NY 11432-6052

Phone

(212) 470-0360

NPI assigned

Dec 29, 2014

Organization subpart

No

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

Authorized official

Name

Steven Wong, M.D

Title

Owner

Phone

(212) 470-0360

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1419811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1419811200000",
    "number": "1245628262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9050 PARSONS BLVD STE 410",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114326052",
            "telephone_number": "212-470-0360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9050 PARSONS BLVD STE 410",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114326052",
            "telephone_number": "212-470-0360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "410 MEDICAL, P.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-29",
        "last_updated": "2014-12-29",
        "status": "A",
        "authorized_official_last_name": "WONG",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "212-470-0360",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "A188292-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2014; 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.