Provider Demographics
NPI:1871103408
Name:QUEENS EMPIRE HEALTH
Entity type:Organization
Organization Name:QUEENS EMPIRE HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ARIN
Authorized Official - Middle Name:
Authorized Official - Last Name:PIRAMZADIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-514-1996
Mailing Address - Street 1:3280 HENDERSON DR STE C-1
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28546-5289
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3123 N DAVIDSON ST STE 103
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28205-1054
Practice Address - Country:US
Practice Address - Phone:252-470-6825
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:QUEENS EMPIRE HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-08-07
Last Update Date:2024-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty