Organization Name: | BAY MEDICAL & DIAGNOSTIC SERVICES, P.C. |
NPI Number: | 1568623460 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ALEKSANDR MARTIROSOV (PRESIDENT) |
Mailing Address: | 1659 78 Str 2nd Fl Brooklyn |
State: | NY US |
Postal Code: | 112141014 |
Phone Number: | 7182341212 |
Fax Number: | |
NPI Enumeration Date: | 06/23/2008 |
NPI Last Update Date: | 08/20/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 209027 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |