Creedmoor Pc

LBN: Creedmoor Pc
Creedmoor Pc is an health care organization with primary practice located at 7925 Winchester Blvd , Queens Village NY 11427-2128. The organization recently has only one registered license in Managed Care Organizations / Health Maintenance Organization, which is considered as the primary health care specialty. Creedmoor Pc can be contacted via phone (718) 464-7500, or through Puccio, Robert via phone (518) 473-0795.

Contact Information

Primary practice address
7925 Winchester Blvd Queens Village NY 11427-2128
Phone: (718) 464-7500
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Puccio, Robert
Phone: (518) 473-0795

Health care specialties

SpecialtyCodeLicense #State
Managed Care Organizations / Health Maintenance Organization 302R00000X

Profile Details

NPI number 1760674519
LBN Legal business name Creedmoor Pc
DBA Doing business as
Authorized official Puccio, Robert
Entity Organization
Organization subpart 1 No
Enumeration date Aug 15th, 2007
Last updated Aug 27th, 2014 - about 10 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1760674519 NPPES
New York MEDICAID 02891110

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