Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

96th Street Junction Blvd Medical PC

Organization Family Medicine Physician · NPI 1588157788

96th Street Junction Blvd Medical PC provides Family Medicine Physician services 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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