HOLLIS HILLS MEDICAL PC (NPI# 1750566584) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750566584 |
| Entity Type | Organization |
| Organization Name | HOLLIS HILLS MEDICAL PC |
| Practice Address |
21715 Peck Ave Queens Village NY 11427-1117 |
| Practice Telephone | 7182172705 |
| Practice Fax Number | 7182172708 |
| Mailing Telephone | 7182172705 |
| Mailing Fax Number | 7182172708 |
| Enumeration Date | 2007-12-28 |
| Last Update Date | 2007-12-28 |
| Authorized Official Name | DR. ROXANA RUIZCARO-CHAVEZ (ASSOCIATE DIRECTOR) |
| Authorized Official Telephone | 7182172705 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
222374 | NY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | NPI | 1538256268 | 01 |
| Street Address |
21715 PECK AVE |
| City | QUEENS VILLAGE |
| State | NY |
| Zip Code | 11427-1117 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073652384 | Gadalla Makar | Psychiatry & Neurology | 21715 Peck Ave, Queens Village, NY 11427-1117 | 2007-02-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255970984 | Hcode LLC | Case Manager/Care Coordinator | 212-29 Hillside Avenue, 6ew, Queens Village, NY 11427 | 2019-12-28 |
| 1659929735 | Adult Choice Np In Adult Heath Pllc | Clinic/Center | 21440 Hillside Ave, Queens, NY 11427 | 2019-08-31 |
| 1063079614 | Caitlin Knapp | Social Worker | Queens Village Jamaica Wellness and Recovery Center, 80-45 Winchester Boulevard (building 73), Queens Village, NY 11427 | 2019-05-20 |
| 1336648120 | Veronica Belinda Simpson V | Licensed Practical Nurse | 79-25 Wichester Blvd, Queens Village, NY 11427 | 2018-02-07 |
| 1427557404 | Frank Oriakhi | Licensed Practical Nurse | 79-25 Winchester Blv, Queens Village, NY 11427 | 2018-02-06 |
| 1376042333 | Mariamma C Oommen | Registered Nurse | 79 25 Winchester Blvd, Queens Village, NY 11427 | 2018-02-06 |
| 1861991838 | Claudette Erica Layne | Registered Nurse | 80-45 Winchester Blvd, Queens Village, NY 11427 | 2018-02-06 |
| 1194224253 | Annamma James I | Registered Nurse | 7925 Winchestetr Blvd, Winchester Bld, Queens, NY 11427 | 2018-02-05 |
| 1740798396 | Michael Mccain | Respite Care | 80-09 Winchester Blvd, Queens Village, NY 11427 | 2018-01-17 |
| 1831600121 | Marcia Maureen Higgins | Registered Nurse | 209-04 Hillside Avenue, Queens Village, NY 11427 | 2017-10-13 |
| Find all providers in zip 11427 | ||||
| Taxonomy Code | 2084P0804X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Child & Adolescent Psychiatry |
| Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093327611 | Adel Mostafavi, Md PC | Psychiatry & Neurology | 104 W 40th St Rm 400, New York, NY 10018-3692 | 2020-08-17 |
| 1023632015 | Child and Adult Clinical Psychiatry PC | Psychiatry & Neurology | 75 Prospect St Ste 110, Huntington, NY 11743-3320 | 2020-06-04 |
| 1598306441 | Place of Mind Child, Adolescent, and Adult Psychiatry P.C. | Psychiatry & Neurology | 240 Central Park S Apt 2h, New York, NY 10019-1435 | 2019-10-02 |
| 1881102267 | Park Avenue Physicians PC | Psychiatry & Neurology | 5 W 86th St Apt 1b, New York, NY 10024-3663 | 2018-01-19 |
| 1518478080 | Diego G. Calabria Physician P.C. | Psychiatry & Neurology | 366 N Broadway Ste 304, Jericho, NY 11753-2000 | 2017-10-23 |
| 1013426865 | Bebsy Estefan Md PC | Psychiatry & Neurology | 3050 Corlear Ave # Phb, Bronx, NY 10463-5180 | 2017-09-25 |
| 1902281629 | Derek Rudge | Psychiatry & Neurology | 1051 Riverside Dr Rm 235, New York, NY 10032-1007 | 2015-07-23 |
| 1275918096 | Dr Omar Bashayan Physician Pllc | Psychiatry & Neurology | 155 W 68th St Apt 1102, New York, NY 10023-5816 | 2015-07-22 |
| 1740676766 | Maura E Tappen | Psychiatry & Neurology | 1860 South Ave, Rochester, NY 14620-4229 | 2015-04-07 |
| 1194119560 | Krishen Persaud | Psychiatry & Neurology | Stony Brook Psychiatric Associates, Ufpc, Sbumc, Hsc Level 10, Rm.020, Stony Brook, NY 11794-8101 | 2015-03-24 |
| Find all providers with the same taxonomy | ||||
| City | QUEENS VILLAGE |
| Zip Code | 11427 |
Please comment or provide details below to improve the information on HOLLIS HILLS MEDICAL PC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.