Organization Name:  UNIVERSITY PHYSICIANS GROUP P C


Practice Location:
65 ROSE AVE  STATEN ISLAND, NY 10306 US
Tel: 718-226-1012  Fax: --

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


Taxonomy:

Primary	Code	Category/Description	State	License Number
N	207K00000X	Physicians Allergy & Immunology
N	207Q00000X	Physicians Family Medicine
N	207R00000X	Physicians Internal Medicine
N	207RE0101X	Physicians Internal Medicine
N	207RG0100X	Physicians Internal Medicine
N	207RG0300X	Physicians Internal Medicine
N	207RR0500X	Physicians Internal Medicine
N	207V00000X	Physicians Obstetrics & Gynecology
N	208000000X	Physicians Pediatrics
N	2080P0210X	Physicians Pediatrics
N	2080P0214X	Physicians Pediatrics
N	2085N0904X	Physicians Radiology
N	2085R0204X	Physicians Radiology
N	2085U0001X	Physicians Radiology
Y	208D00000X	Physicians General Practice

Other Provider Identifiers:

Issuer	Number	State	Type
	01256440	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