Be Evergreen Medical PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

198832 Issued in NY

Legal business name

BE EVERGREEN MEDICAL PC

Practice address

13329 41St Rd Ste 1a
Flushing, NY 11355-3671

Phone

(718) 886-8180

NPI assigned

Sep 11, 2014

Organization subpart

No

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

Authorized official

Name

Anna Zhu

Title

Manager

Phone

(718) 886-8180

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1410393600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1420416000000",
    "number": "1346641172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13329 41ST RD STE 1A",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113553671",
            "telephone_number": "718-886-8180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13329 41ST RD STE 1A",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113553671",
            "telephone_number": "718-886-8180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BE EVERGREEN MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-11",
        "last_updated": "2015-01-05",
        "status": "A",
        "authorized_official_last_name": "ZHU",
        "authorized_official_first_name": "ANNA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "718-886-8180"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "198832",
            "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 Jan 5, 2015; 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.