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OCTOBER MEDICAL PC
NPI 1639868763
Family Medicine in Jackson Heights, NY

Active since May 04, 2023
3704 91ST ST STE D, JACKSON HEIGHTS, NY 11372(929) 401-4936(516) 534-4666 Get Directions Write a Review

NPPES record last updated: January 11, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About October Medical Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

OCTOBER MEDICAL PC (NPI 1639868763) is a healthcare organization registered as a family medicine in Jackson Heights, New York and active in the NPI registry since May 2023. The organization lists Sonia Evadne Walker-adamson, Do, as its authorized official.

NPPES Registry Identity

NPI1639868763
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameOCTOBER MEDICAL PC
Location Address3704 91ST ST STE DJackson Heights, NY 11372-7909
Mailing Address3704 91st St Ste DJackson Heights, NY 11372-7909 · (929) 401-4936 · Fax (516) 534-4666
Phone(929) 401-4936
Fax(516) 534-4666
Organization SubpartNo
Authorized OfficialSonia Evadne Walker-adamsonDo · (516) 404-6550
Enumeration DateMay 4, 2023
Last NPPES UpdateJanuary 11, 2024
NPPES CertifiedOctober 20, 2023
✔ NPI 1639868763 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
3704 91ST ST STE D, Jackson Heights, NY 11372
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Compliance 33D2292749

October Medical PC · Jackson Heights, NY
Expired · Jul 31, 2026
CLIA Number33D2292749
Laboratory TypePhysician Office
Certificate Effective DateOctober 30, 2023
Certificate Expiration DateJuly 31, 2026
Laboratory DirectorDr. Sonia Walker
Laboratory Phone(929) 401-4936
Laboratory LocationOctober Medical PC37-04 91st Street, Suite D, Jackson Heights, NY 11372
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is October Medical PC's NPI number?

The NPI number for October Medical PC is 1639868763. It was assigned to this organization in the NPPES registry on May 4, 2023.

Where is October Medical PC located?

October Medical PC is located at 3704 91st St Ste D, Jackson Heights, NY 11372. The listed phone number is (929) 401-4936.

What is October Medical PC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

When was this NPI record last updated?

The NPPES record for October Medical PC was last updated on January 11, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.