Organization · NPI-2

Ajs Brooklyn Medical Practice PC

Clinic/Center · Bronx, NY

NPI number1619626454
StatusActive
Last updated in NPPESMar 21, 2022

Details

NPI
1619626454
Entity type
Organization (NPI-2)
Legal business name
Ajs Brooklyn Medical Practice PC
Organization subpart
No
Enumeration date
Mar 21, 2022
Certification date
Mar 3, 2022
Last updated
Mar 21, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261Q00000X Clinic/Center––Yes

Practice location

655 Morris Ave # 2
Bronx, NY 10451-4898

Phone 347-736-9046

Mailing address

6255 W Sunset Blvd Fl 21
Los Angeles, CA 90028-7422

Phone 323-860-5200

Authorized official

Lyle Honig
Cfo
3238602326

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