Organization Name: | NYC BROOK MEDICAL LLC |
NPI Number: | 1255705075 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | T BROWN (MANAGER) |
Mailing Address: | 183 Wilson St Ste 205 Brooklyn |
State: | NY US |
Postal Code: | 112117578 |
Phone Number: | 7184444446 |
Fax Number: | 7184444009 |
NPI Enumeration Date: | 11/17/2015 |
NPI Last Update Date: | 11/17/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |