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Antidote A.I. Health Of Fl P.A.

Family Medicine in New York, NY. Organization (NPI-2).

NPI number1164095253
StatusActive
Last updated in NPPESFeb 4, 2022

Details

NPI
1164095253
Entity type
Organization (NPI-2)
Legal business name
Antidote A.I. Health Of Fl P.A.
Organization subpart
No
Enumeration date
Jul 19, 2021
Certification date
Feb 4, 2022
Last updated
Feb 4, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family Medicine––Yes
207R00000X Internal Medicine––

Practice location

1460 Broadway
New York, NY 10036-7329

Phone 845-213-3504

Mailing address

1460 Broadway
New York, NY 10036-7329

Authorized official

Baruch Berzon
Owner
8452133504

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