TITAN PRIMARY CARE, INC (NPI# 1053921957) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053921957 |
| Entity Type | Organization |
| Organization Name | TITAN PRIMARY CARE, INC |
| Practice Address |
3753 90th St Ste 11 Jackson Heights NY 11372-7879 |
| Practice Telephone | 6237386372 |
| Mailing Telephone | 6237386372 |
| Enumeration Date | 2020-08-05 |
| Last Update Date | 2020-08-05 |
| Authorized Official Name | PABLO ESTEBAN BUSTOS (CEO) |
| Authorized Official Telephone | 6237386372 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QA0401X |
Family Medicine Specialization: Addiction Medicine |
Allopathic & Osteopathic Physicians |
| Street Address |
3753 90TH ST STE 11 |
| City | JACKSON HEIGHTS |
| State | NY |
| Zip Code | 11372-7879 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063028967 | Adults Medical Care, P.C. | Internal Medicine | 89 04 Northern Blvd, Ground Floor, Jackson Heights, NY 11372 | 2020-09-17 |
| 1568077014 | Toshihide Kuroe | Student in an Organized Health Care Education/Training Program | 35-20 90th Street, Jackson Heights, Queens, New York, NY 11372 | 2020-09-11 |
| 1134732142 | Wendell Jamias Abad | Physical Therapy Assistant | 90-33 Elmhurst Ave., Jackson Heights, NY 11372 | 2020-08-28 |
| 1508489022 | Shereda Lawrence | Nurse Practitioner | 86-10 Roosevelt Ave, Jackson Heights, NY 11372 | 2020-05-19 |
| 1710513395 | Golden Age Home Care, Inc | Home Health | 71-16 35th Street, Jackson Heights, NY 11372 | 2020-03-16 |
| 1497210611 | Andree Michel Decastro | Counselor | 76-05 Roosevelt Ave, 2nd Fl, Flushing, NY 11372 | 2019-02-01 |
| 1598234031 | Bithi Roy | Social Worker | 37-08 91st St Jackson Heights, Suit 3a, Jackson Heights, NY 11372 | 2018-11-14 |
| 1225506496 | Michael Anavian | Counselor | 7410 35 Ave Suite 107w, Jackson Heights, NY 11372 | 2018-11-06 |
| 1982189171 | Jackson Pharmacy Inc. | Pharmacy | 7102, 37th Avenue, Jackson Heights, NY 11372 | 2018-10-03 |
| 1689155814 | Sostenes Batista Lima | Counselor | 35-25 86th St Apt 1f, Jackson Heights, NY 11372 | 2018-08-26 |
| Find all providers in zip 11372 | ||||
| Taxonomy Code | 207QA0401X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Addiction Medicine |
| A family medicine physician who specializes in the diagnosis and treatment of addictions. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) was, but is no longer issued by the American Osteopathic Board of Family Physicians. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205467842 | Tara Healthcare LLC | Family Medicine | 157 Bleecker St # 1, New York, NY 10012-1625 | 2020-02-03 |
| 1548820608 | Cs Medical Associates, P.C. | Family Medicine | 727 N Broadway Ste B1, Massapequa, NY 11758-2348 | 2019-06-19 |
| 1992210231 | Cs Medical Associates, PC | Family Medicine | 100 Granny Road, Suite 2, Farmingville, NY 11738 | 2017-12-08 |
| 1881120376 | Yonina Mar | Family Medicine | 10 Nathan D. Perlman Pl, Msbi Psychiatry, Bernstein Pavilion, Room 7b15, New York, NY 10003 | 2017-05-03 |
| 1457771842 | Gary Demara | Family Medicine | 220 Tom Miller Rd, Plattsburgh, NY 12901-6427 | 2014-04-24 |
| 1144540022 | Michael James Reardon | Family Medicine | 41 Dunlop Rd, Huntington, NY 11743-3932 | 2010-06-02 |
| 1710123963 | Fred William Marcus | Family Medicine | 770 Jericho Tpke, Syosset, NY 11791-4516 | 2008-12-17 |
| 1740447101 | Bernard Charles Borkowski | Family Medicine | 2025 Kenneth Rd, Merrick, NY 11566-5508 | 2008-05-21 |
| 1023280740 | Charles Pouponneau | Family Medicine | 147-20 Archer Avenue, Jamaica, NY 11435 | 2008-04-02 |
| 1356562805 | Mario Douyon De Azevedo | Family Medicine | 3878 State Route 11, Suite 2, Malone, NY 12953-3726 | 2007-05-01 |
| Find all providers with the same taxonomy | ||||
| City | JACKSON HEIGHTS |
| Zip Code | 11372 |
Please comment or provide details below to improve the information on TITAN PRIMARY CARE, INC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.