Provider Demographics
NPI:1730336413
Name:ALL IN ONE MEDICAL CARE PC
Entity type:Organization
Organization Name:ALL IN ONE MEDICAL CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:CLAUDE
Authorized Official - Last Name:DEMETRIUS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-393-3075
Mailing Address - Street 1:13876 QUEENS BLVD FL 1
Mailing Address - Street 2:
Mailing Address - City:BRIARWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:11435-2930
Mailing Address - Country:US
Mailing Address - Phone:718-850-6345
Mailing Address - Fax:718-559-4895
Practice Address - Street 1:5515 VAN CLEEF ST
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:NY
Practice Address - Zip Code:11368-3907
Practice Address - Country:US
Practice Address - Phone:718-393-3075
Practice Address - Fax:718-393-3096
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-25
Last Update Date:2009-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
No2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No2081N0008XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationNeuromuscular MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00951753Medicaid
A62227Medicare UPIN
NY43D081Medicare PIN