Organization · NPI-2

1501 Medical PC

Family Medicine · Brooklyn, NY

NPI number1083921779
StatusActive
Last updated in NPPESSep 2, 2010

Details

NPI
1083921779
Entity type
Organization (NPI-2)
Legal business name
1501 Medical PC
Organization subpart
No
Enumeration date
Sep 2, 2010
Last updated
Sep 2, 2010

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family Medicine––Yes

Practice location

1501 80th St Ste 1
Brooklyn, NY 11228-2533

Phone 718-837-2660

Mailing address

1501 80th St Ste 1
Brooklyn, NY 11228-2533

Phone 718-837-2660

Authorized official

Ilya Pavlov Akselrud
Owner
7188372660

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