PROVISION AT NEW YORK LLC

NPI: 1467749630 · Organization · Active

Primary Specialty

Clinic/Center

Practice Location

6135 JUNCTION BLVD
REGO PARK, NY 11374-2771 Map ↗
Phone: 718-760-7862
Fax: 718-760-7861

Mailing Address

7285 YELLOWSTONE BLVD
FOREST HILLS, NY 11375-4133 Map ↗
Phone: 718-760-7862
Fax: 718-760-7861

Used for billing & correspondence; clinical visits at the Practice Location above.

All Specialties & Licenses

  • Clinic/Center Primary (license: TUV006676, NY)
  • Primary Care Clinic/Center — Primary Care (license: TUV006676, NY)

NPI Registration

Enumerated: 2011-07-07

Last CMS Update: 2012-07-31