NPI 1679958052

Queensvillagedentalcare,p.C.

Organisation Health Maintenance Organization Queens Village, NY

Practice location

Address: 22005 94th Dr, Queens Village, NY 11428-2105
Phone: (718) 465-3265
Fax: (718) 776-4260

Authorised official

Name: Terence Teekah Mahase
Title: President
Phone: (718) 465-3265

Registered specialties

Health Maintenance Organization Primary

Managed Care Organizations Taxonomy 302R00000X Licence 042201 (NY)

Other Health Maintenance Organization providers in New York →

Registry record

NPI: 1679958052
Entity type: Organization
NPI issued: 27 Jul 2015
Record last updated: 27 Jul 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.