Organization Name:  BOOTH MEDICAL ASSOCIATES PC


Practice Location:
5645 MAIN ST  FLUSHING, NY 11355 US
Tel: 718-670-2236  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

Primary	Code	Category/Description	State	License Number
X	207K00000X	Physicians Allergy & Immunology
X	207N00000X	Physicians Dermatology
X	207R00000X	Physicians Internal Medicine
X	207RC0000X	Physicians Internal Medicine
X	207RC0200X	Physicians Internal Medicine
X	207RE0101X	Physicians Internal Medicine
X	207RG0100X	Physicians Internal Medicine
X	207RG0300X	Physicians Internal Medicine
X	207RH0003X	Physicians Internal Medicine
X	207RI0008X	Physicians Internal Medicine
X	207RI0200X	Physicians Internal Medicine
X	207RN0300X	Physicians Internal Medicine
X	207RP1001X	Physicians Internal Medicine
X	207RR0500X	Physicians Internal Medicine
X	2084N0400X	Physicians Psychiatry & Neurology

Other Provider Identifiers:

Issuer	Number	State	Type
BCBS	W9411	NY	01
	00923859	NY	05

Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin