QUEENS CBOC (895)    INSTITUTION (4)

Name Value
NAME QUEENS CBOC
STATE NEW YORK
STREET ADDR. 1 41-03 QUEENS BOULEVARD
CITY QUEENS
ZIP 11104-2801
OFFICIAL VA NAME NORTH QUEENS CLINIC
STATUS National
ASSOCIATIONS
BILLING FACILITY NAME QUEENS VA CLINIC
ST. ADDR. 1 (MAILING) 41-03 QUEENS BOULEVARD
CITY (MAILING) QUEENS
STATE (MAILING) NEW YORK
ZIP (MAILING) 11104-2801
EFFECTIVE DATE/TIME
  • 2007-01-08 00:00:00
    STATUS:   ACTIVE
    NPI:   1558309047
TAXONOMY CODE
LOCATION TIMEZONE EASTERN
COUNTRY USA
AGENCY CODE VA
POINTER TO AGENCY VA
STATION NUMBER 526GD
IDENTIFIER
  • CODING SYSTEM:   NPI
    ID:   1558309047
  • CODING SYSTEM:   VASTANUM
    ID:   526GD
  • CODING SYSTEM:   CLIA
    ID:   33D1040604