OCTOBER MEDICAL PC NPI 1639868763

NPI Information

  • NPI: 1639868763
  • Provider Name: OCTOBER MEDICAL PC
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Organization
  • CLIA Number: 33D2292749
  • Address: 3704 91ST ST STE D
    JACKSON HEIGHTS, NY
    ZIP 11372
  • Phone: (929) 401-4936

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NPI Details

OCTOBER MEDICAL PC is a family medicine in Jackson Heights, NY. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. OCTOBER MEDICAL PC NPI is 1639868763. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

3704 91ST ST STE D
JACKSON HEIGHTS, NY
ZIP 11372-909
Phone: (929) 401-4936
Fax: (516) 534-4666

The provider's authorized official is Sonia Evadne Walker-adamson .
The authorized official title is Do and has the following contact phone number (516) 404-6550.

The CLIA number assigned to this NPI record is 33D2292749 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 5/4/2023 and was last updated on 1/11/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily MedicineYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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