Organization · NPI-2

Ajs Brooklyn Medical Practice PC

Clinic/Center · Bronx, NY

NPI number1639735483
StatusActive
Last updated in NPPESSep 11, 2019

Details

NPI
1639735483
Entity type
Organization (NPI-2)
Legal business name
Ajs Brooklyn Medical Practice PC
Organization subpart
No
Enumeration date
May 17, 2019
Last updated
Sep 11, 2019

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 323-436-5025 · Fax 833-241-7615

Authorized official

Donna Stidham
Chief, Managed Care
3234365025

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