Basic Information
| Provider Information | |||||||||
| NPI: | 1083126155 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HJC MEDICINE PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 131 E AMES CT | ||||||||
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| City: | PLAINVIEW | ||||||||
| State: | NY | ||||||||
| PostalCode: | 118032317 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5164145865 | ||||||||
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| Practice Location | |||||||||
| Address1: | 13620 38TH AVE STE 5D | ||||||||
| Address2: | |||||||||
| City: | FLUSHING | ||||||||
| State: | NY | ||||||||
| PostalCode: | 113544264 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6465992900 | ||||||||
| FaxNumber: | 7182538117 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/30/2017 | ||||||||
| LastUpdateDate: | 10/30/2017 | ||||||||
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| AuthorizedOfficialLastName: | FARLEY | ||||||||
| AuthorizedOfficialFirstName: | BRIANA | ||||||||
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| AuthorizedOfficialTitleorPosition: | CREDENTIALING COORDINATOR | ||||||||
| AuthorizedOfficialTelephone: | 5164145865 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207VM0101X | 198540 | NY | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Maternal & Fetal Medicine |
No ID Information.