Organization · NPI-2

53rd Street Medical PC

Internal Medicine · Brooklyn, NY

NPI number1326326612
StatusActive
Last updated in NPPESAug 3, 2011

Details

NPI
1326326612
Entity type
Organization (NPI-2)
Legal business name
53rd Street Medical PC
Organization subpart
No
Enumeration date
Aug 3, 2011
Last updated
Aug 3, 2011

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207R00000X Internal Medicine160217-1NYYes

Practice location

471 53rd St
Brooklyn, NY 11220-2712

Phone 718-492-4109

Mailing address

471 53rd St
Brooklyn, NY 11220-2712

Phone 718-492-4109

Authorized official

Robert Zwitiashvili
Director
7184924109

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