96TH STREET JUNCTION BLVD MEDICAL PC (NPI# 1588157788) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588157788 |
| Entity Type | Organization |
| Organization Name | 96TH STREET JUNCTION BLVD MEDICAL PC |
| Practice Address |
5548 96th St Corona NY 11368 |
| Mailing Address |
5548 96th St Corona NY 11368-3009 |
| Practice Telephone | 7186061199 |
| Enumeration Date | 2018-06-12 |
| Last Update Date | 2018-08-13 |
| Authorized Official Name | WILDER RUCKER (OWNER) |
| Authorized Official Telephone | 7186061199 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Street Address |
5548 96TH ST |
| City | CORONA |
| State | NY |
| Zip Code | 11368 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669614293 | M&m Medical PC | Internal Medicine | 5548 96th St, Corona, NY 11368-3009 | 2009-03-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760014039 | Marukh Naeem | Behavioral Analyst | 11119a Roosevelt Ave, Apt 2r, Apt 2r, Corona, NY 11368 | 2020-02-05 |
| 1164072989 | Tonyia Michelle Madison | Counselor | 34-10 108 Street, Corona, Queens, NY 11368 | 2019-09-13 |
| 1962987347 | Sinead Anel Ulloa | Speech-Language Pathologist | 10420 37th Rd, Corona, NY 11368 | 2018-10-01 |
| 1245725779 | Bracha Namdar | Optometrist | 103-06 Roosevelt Ave, Corona, NY 11368 | 2018-06-27 |
| 1548758220 | Karina Elizabeth Carrasco | Specialist | 96- 32 46th Ave, Corona, NY 11368 | 2018-04-27 |
| 1134634033 | Nicole Iuculano | Speech-Language Pathologist | 43-18 97th Place, Corona, NY 11368 | 2017-12-13 |
| 1558880831 | Abenaa Nyame Danquah | Registered Nurse | 55-25 98th Place, Apt 1k, Corona, NY 11368 | 2017-09-18 |
| 1063940443 | Brand Rx Pharmacy Corp | Pharmacy | 97-05 A 57th Avenue, Corona, NY 11368 | 2017-05-30 |
| 1427595909 | Richelle Krish Sumaoy Colmenares | Physical Therapist | 3744 104th St., Corona, New York City, NY 11368 | 2017-01-23 |
| 1235674342 | 39th Avenue Physical Therapy PC | Clinic/Center | 103-18c 39 Ave, Corona, NY 11368 | 2016-12-28 |
| Find all providers in zip 11368 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851931364 | Infinity Medical Care, Inc. | Family Medicine | 1820 Fullerton Ave Ste No260, Corona, CA 92881-3160 | 2020-01-13 |
| 1649708397 | Greta Eugenia Rios-steed | Family Medicine | 495 E Rincon St Ste 215, Corona, CA 92879-1378 | 2017-05-25 |
| 1104351097 | Victoria S. Brown | Family Medicine | 2071 Compton Ave #103, Corona, CA 92881 | 2017-04-27 |
| 1659786192 | Merlin Ann Sunny | Family Medicine | 341 Magnolia Ave Ste 201, Corona, CA 92879-3332 | 2014-06-24 |
| 1396164869 | Mi Tu Quan | Family Medicine | 5828 99th St, Corona, NY 11368 | 2014-04-14 |
| 1801232384 | Farhan Saeed Khan | Family Medicine | 2871 New Castle Way, Corona, CA 92879-6164 | 2013-05-11 |
| 1295093953 | Central Occupational Medicine Providers - Ontario, A Medical Corporati | Family Medicine | 1690 W 6th St, Suite K, Corona, CA 92882-2910 | 2012-05-01 |
| 1982983458 | Optimum Wellness and Longevity Inc | Family Medicine | 1315 Corona Pointe Ct, Suite 101, Corona, CA 92879-1764 | 2011-08-15 |
| 1326333089 | Cogent Healthcare of California | Family Medicine | 2275 Sampson Ave, Corona, CA 92879-3400 | 2011-06-10 |
| 1316248842 | Harishkumar Ganeshbhai Patel | Family Medicine | 1312 Alee Cir, Corona, CA 92882-7343 | 2010-11-15 |
| Find all providers in CORONA | ||||
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| 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.