Provider Demographics
NPI:1770803165
Name:QUEENS CROSSING SURGERY GROUP PLLC
Entity type:Organization
Organization Name:QUEENS CROSSING SURGERY GROUP PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALBERT
Authorized Official - Middle Name:S
Authorized Official - Last Name:JEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-670-0006
Mailing Address - Street 1:13620 38TH AVE
Mailing Address - Street 2:SUITE 7J
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-4233
Mailing Address - Country:US
Mailing Address - Phone:718-670-0006
Mailing Address - Fax:718-701-5883
Practice Address - Street 1:13620 38TH AVE
Practice Address - Street 2:SUITE 7J
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-4233
Practice Address - Country:US
Practice Address - Phone:718-670-0006
Practice Address - Fax:718-701-5883
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-08
Last Update Date:2010-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical