Evergreen Family Medical Services,P.C.

LBN: Evergreen Family Medical Services,P.C.
Evergreen Family Medical Services,P.C. is an health care organization with primary practice located at 743 58Th St , Brooklyn NY 11220-3916. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty. Evergreen Family Medical Services,P.C. can be contacted via phone (718) 765-0088, or through Chan, Raymond via phone (718) 765-0088.

Contact Information

Primary practice address
743 58Th St Brooklyn NY 11220-3916
Phone: (718) 765-0088
Fax: (718) 567-8208
Website:
Map and Directions
Authorized official contact:
Name: Chan, Raymond Doctor of Medicine (MD)
Phone: (718) 765-0088

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X

Profile Details

NPI number 1891761243
LBN Legal business name Evergreen Family Medical Services,P.C.
DBA Doing business as
Authorized official Chan, Raymond Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Feb 26th, 2006
Last updated Oct 1st, 2012 - about 13 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 1891761243 NPPES
New York MEDICAID 02720354

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