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

Dr. Emerth Lance Coburn, MD

Individual provider Internal Medicine Physician · NPI 1477544096

Dr. Emerth Lance Coburn, MD is an Internal Medicine in Queens Village, New York. Qualified in 1995, 31 years ago. Practices with Fresh Meadows Physician Practice PLLC, a 33-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
31
Licensed in
NY
In the registry since
2005
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

21401 110th Ave
Queens Village, NY 11429-1906
Phone: (929) 615-6447
Fax: (718) 276-4783
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 198832 (NY)
Internal Medicine Physician Taxonomy 207R00000X · Licence 198832 (NY)

Record details

NPI number1477544096
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedNovember 2, 2005
Last updated in NPPESMarch 5, 2025
Certification dateMarch 5, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyINTERNAL MEDICINE
Medical schoolOTHER
Graduated 1995 (31 years in practice)
Group practice Fresh Meadows Physician Practice Pllc — 33 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Queens Village