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 provides Specialist services 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 Not confirmed with CMS for 12 years — call before visiting
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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