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

Metro Physical Medicine PC

Organization Specialist · NPI 1679903413

Metro Physical Medicine PC is a Specialist in Jamaica, New York. Licensed in New York. Registered with an NPI since 2013.

Licensed in
NY
In the registry since
2013
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

10825 Merrick Blvd
Jamaica, NY 11433-2906
Phone: (718) 658-9700
Fax: (718) 658-9703
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Specialist (primary) Taxonomy 174400000X · Licence 194218 (NY)

Record details

NPI number1679903413
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Samuel Theagene — Owner · (718) 658-9700
NPI enumeratedNovember 14, 2013
Last updated in NPPESNovember 14, 2013
Mailing address10825 Merrick Blvd, Jamaica, NY 11433-2906

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