Advanced Wound Care Medical PC
Internal Medicine in Brooklyn, NY. Organization (NPI-2).
NPI number1699726315
StatusActive
Last updated in NPPESOct 17, 2007
Details
- NPI
- 1699726315
- Entity type
- Organization (NPI-2)
- Legal business name
- Advanced Wound Care Medical PC
- Organization subpart
- No
- Enumeration date
- May 15, 2006
- Last updated
- Oct 17, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207R00000X | Internal Medicine | 218265 | NY | Yes |
| 208D00000X | General Practice | 227059 | NY | |
| 208600000X | Surgery | 150869 | NY | |
| 208D00000X | General Practice | 156598 | NY | |
| 208600000X | Surgery | 087860 | NY |
Practice location
454 Avenue UBrooklyn, NY 11223-4011
Phone 718-382-3400 · Fax 718-382-3420
Mailing address
454 Avenue UBrooklyn, NY 11223-4011
Phone 718-382-3400 · Fax 718-382-3420
Authorized official
Sergei Kochlatyi
Medical Director
7183823400
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