Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

96th Street Junction Blvd Medical PC

Organization Family Medicine Physician · NPI 1588157788

96th Street Junction Blvd Medical PC is a Family Medicine Physician in Corona, New York. Registered with an NPI since 2018.

In the registry since
2018
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

5548 96th St
Corona, NY 11368
Phone: (718) 606-1199
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X

Record details

NPI number1588157788
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Wilder Rucker — Owner · (718) 606-1199
NPI enumeratedJune 12, 2018
Last updated in NPPESAugust 13, 2018
Mailing address5548 96th St, Corona, NY 11368-3009

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