Corona Comprehensive Medical Care, P.C.

Primary specialty

SpecialistTaxonomy code 174400000X

License

157714 Issued in NY

Legal business name

CORONA COMPREHENSIVE MEDICAL CARE, P.C.

Practice address

10809 52ND Ave
Corona, NY 11368-3300

Phone

(718) 393-0600

Fax

(718) 393-3096

NPI assigned

Dec 13, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Jean Claude Demetrius, M.D.

Title

Owner

Phone

(718) 393-0600

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1972664035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108-09A 52ND. AVE.",
            "city": "CORONA",
            "state": "NY",
            "postal_code": "113683300",
            "telephone_number": "718-393-0600",
            "fax_number": "718-393-3096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10809 52ND AVE",
            "city": "CORONA",
            "state": "NY",
            "postal_code": "113683300",
            "telephone_number": "718-393-0600",
            "fax_number": "718-393-3096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORONA COMPREHENSIVE MEDICAL CARE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DEMETRIUS",
        "authorized_official_first_name": "JEAN",
        "authorized_official_middle_name": "CLAUDE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-393-0600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NY",
            "license": "157714",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Corona, NY
• Providers in Corona, NY by specialty
• Specialist in New York

• 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.