Ajs Brookyln Medical Practice PC
Clinic/Center in Jamaica, NY. Organization (NPI-2).
NPI number1134594955
StatusActive
Last updated in NPPESSep 11, 2019
Details
- NPI
- 1134594955
- Entity type
- Organization (NPI-2)
- Legal business name
- Ajs Brookyln Medical Practice PC
- Organization subpart
- No
- Enumeration date
- Dec 4, 2015
- Last updated
- Sep 11, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261Q00000X | Clinic/Center | – | – | Yes |
Practice location
161-21 Jamaica Ave7th Floor
Jamaica, NY 11432
Phone 718-896-2500 · Fax 718-459-8515
Mailing address
6255 W Sunset Blvd Fl 21Los Angeles, CA 90028-7422
Phone 323-860-5200 · Fax 833-241-7615
Authorized official
Donna Stidham
Chief, Managed Care
3234365025
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