Queens Medical South PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

105860 Issued in NY

Legal business name

QUEENS MEDICAL SOUTH PC

Practice address

3939 63Rd St
Woodside, NY 11377-3648

Phone

(646) 397-0005

Fax

(888) 388-5171

NPI assigned

Jan 23, 2012

Organization subpart

No

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

Authorized official

Name

Sung Kim, MD

Title

President

Phone

(646) 397-0005

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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

• Orestes Germones, PT

  • Physical Therapist
  • Elmhurst, NY
  • NPI 1649592403
  NPD (past)
• Adelaida Mijos Laga, P.T.

  • Physical Therapist
  • Bronx, NY
  • NPI 1477885879
  NPD (past)

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

{
    "created_epoch": "1327276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327276800000",
    "number": "1881965804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3939 63RD ST",
            "city": "WOODSIDE",
            "state": "NY",
            "postal_code": "113773648",
            "telephone_number": "646-397-0005",
            "fax_number": "888-388-5171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3939 63RD ST",
            "city": "WOODSIDE",
            "state": "NY",
            "postal_code": "113773648",
            "telephone_number": "646-397-0005",
            "fax_number": "888-388-5171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUEENS MEDICAL SOUTH PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-23",
        "last_updated": "2012-01-23",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "SUNG",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "646-397-0005",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "105860",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Queens Boulevard Extended Care Facility
• Queens Boulevard Extended Care Facility Corp
• Queens Boulevard Extended Care Facility Dialysis Center LLC
• Queens Boulevard Extended Care Facility Management LLC
• Queens County Podiatry PC
• Queens Wound & Medical Care PC
• Hepshiba Rita S Quijote, PT
• Octavio Quijote Jr., PT
• Deirdre Anne Quinlan, CCC-SLP
• Arlene Quino

• All providers in Woodside, NY
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2012; 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.