CORRECTIONAL MEDICAL ASSOCIATES OF NEWYORK, P.C. (NPI# 1669817938) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669817938 |
| Entity Type | Organization |
| Organization Name | CORRECTIONAL MEDICAL ASSOCIATES OF NEWYORK, P.C. |
| Other Organization Name | PHS MEDICAL SERVICES, P.C. |
| Practice Address |
4904 19th Ave Astoria NY 11105-1002 |
| Practice Telephone | 3477747015 |
| Practice Fax Number | 3477748051 |
| Mailing Telephone | 3477747015 |
| Mailing Fax Number | 3477748051 |
| Enumeration Date | 2013-05-01 |
| Last Update Date | 2013-05-01 |
| Authorized Official Name | DR. JAY COWAN (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 3477747015 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | Suppliers | ||
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| PHS Medical Services, P.C. | Former Legal Business Name - Organization |
| Street Address |
4904 19TH AVE |
| City | ASTORIA |
| State | NY |
| Zip Code | 11105-1002 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992723753 | Aung Khine Oo | Internal Medicine | 4904 19th Ave, Astoria, NY 11105-1002 | 2006-07-18 |
| 1689067019 | Christopher Wayne Johnson | Counselor | 4904 19th Ave, Astoria, NY 11105-1002 | 2015-03-10 |
| 1437547957 | Brian Michael Burns | Registered Nurse | 4904 19th Ave, Astoria, NY 11105-1002 | 2015-01-06 |
| 1700274305 | James Patrick Cassar | Nurse Practitioner | 4904 19th Ave, Astoria, NY 11105-1002 | 2015-01-05 |
| 1770980252 | Corizon | Community/Behavioral Health | 4904 19th Ave, Astoria, NY 11105-1002 | 2014-11-26 |
| 1609276534 | Adem Martin Geraghty | Registered Nurse | 4904 19th Ave, Astoria, NY 11105-1002 | 2014-08-28 |
| 1477973519 | Christine Edmondson | Nurse Practitioner | 4904 19th Ave, Astoria, NY 11105-1002 | 2014-04-16 |
| 1356778591 | Christopher Wayne Chan | Pharmacist | 4904 19th Ave, Astoria, NY 11105-1002 | 2013-10-02 |
| 1356783476 | Anna T Richards | Registered Nurse | 4904 19th Ave, Astoria, NY 11105-1002 | 2013-07-18 |
| 1609210178 | Correctional Dental Associates of New York | Dentist | 4904 19th Ave, Astoria, NY 11105-1002 | 2013-04-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639640345 | Bridget Mackin | Counselor | 2263 41st Street, Apt 1f, Astoria, NY 11105 | 2018-12-07 |
| 1487154597 | Five Star Assessment Corp | Specialist/Technologist | 2135 47 Street, Suite 2, Astoria, NY 11105 | 2018-02-15 |
| 1154843076 | Stefania Anne Vendome | Physician Assistant | 23-38 28th Street, Astoria, NY 11105 | 2017-07-12 |
| 1164942330 | Kara Lorraine Gerbino | Registered Nurse | 2325 31st St Ste 301, Astoria, NY 11105 | 2017-06-20 |
| 1669908828 | Gerlie H Estores | Licensed Practical Nurse | 2257 23rd Street, 2nd Floor, Astoria, NY 11105 | 2017-05-10 |
| 1558809665 | Tasrina Khan | Behavioral Analyst | 24-13 23rd Ave, Astoria, NY 11105 | 2017-02-09 |
| 1356892988 | Maria Tsoukias | Behavioral Analyst | 21-21 24th Street, Astoria, NY 11105 | 2016-10-19 |
| 1356705602 | Ahmed Y Nasser | Pharmacist | 21 09 A 31st Street, Pharmacare Plus Pharmacy, Astoria, NY 11105 | 2016-04-12 |
| 1194185363 | Sisters of The Good Shepherd | Social Worker | 25-30 21 Avenue, Astoria, NY 11105 | 2016-03-02 |
| 1154741551 | Latifat Okeke | Nurse Practitioner | 49-04 19th Ave, Rikers Island Correctional Facility, Astoria, NY 11105 | 2014-04-24 |
| Find all providers in zip 11105 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
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| 1801919980 | Sonny Park PC | Clinic/Center | 2120 Exchange St, Ste 200, Astoria, OR 97103-3365 | 2007-04-06 |
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| 1790347243 | Jacob Jacoby Md | Clinic/Center | 100 Route 59 Ste 103, Suffern, NY 10901-4927 | 2019-07-05 |
| 1174089056 | City Medical of Upper East Side, Pllc | Clinic/Center | 216 E 14th St Ste B, New York, NY 10003-4105 | 2019-02-15 |
| 1770051690 | Seagull Medical Services | Clinic/Center | 105 Norwalk Ave, Staten Island, NY 10314-5658 | 2018-11-08 |
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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.