Enterprise Medical PC
Organization Active NPI Specialist · College Point, NY
NPI 1497119655 · NPPES record last updated Apr 13, 2016
Key facts
- NPI
- 1497119655
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Specialist 174400000X
- License
- 212919 (NY)
- Legal business name
- ENTERPRISE MEDICAL PC
- Practice address
- 1434 110TH St
College Point, NY 11356-1446 - Phone
- (718) 534-0689
- NPI assigned
- Apr 13, 2016
- Organization subpart
- No
Authorized official
- Name
- Dr. Joseph Golyan, MD
- Title
- Owner
- Phone
- (718) 534-0689
Practitioners 2
-
Joseph Golyan, MD
-
Louis Kiwala, PA-C, AP,L.AC.,DNBAO
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20160531001507 | NY | Part B Supplier - Clinic/Group Practice | 3678863867 |
Receives reassigned benefits from 2 practitioners Practice locations: Forest Hills, NY |
National Provider Directory
Locations
6902 Austin St
Fl 2
Forest Hills, NY 11375
Phone (516) 424-2862
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist |
174400000X | 212919 | NY | Yes |
Addresses
Primary practice location
1434 110TH St
College Point, NY 11356-1446
Mailing address
1434 110TH St
College Point, NY 11356-1446
Phone (718) 534-0689
Other providers in College Point, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 13, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.