Provider Demographics
NPI:1902281850
Name:JAMAICA MEDICAL CENTER NY PC
Entity Type:Organization
Organization Name:JAMAICA MEDICAL CENTER NY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MITCHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:KURK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-487-4016
Mailing Address - Street 1:9016 SUTPHIN BLVD
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11435-3636
Mailing Address - Country:US
Mailing Address - Phone:718-487-4016
Mailing Address - Fax:718-487-3957
Practice Address - Street 1:9016 SUTPHIN BLVD
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11435-3636
Practice Address - Country:US
Practice Address - Phone:718-487-4016
Practice Address - Fax:718-487-3957
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-21
Last Update Date:2015-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty