MEDICARE: DAVID MINZER, DO , PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1235587056
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DAVID MINZER, DO , PLLC

Provider Business Mailing Address
First Line	:	3410 AVENUE P
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11234-3441
Country	:	US
Telephone Number	:	347-618-9840
Fax Number	:

Provider Business Practice Location Address
First Line	:	3410 AVENUE P
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11234-3441
Country	:	US
Telephone Number	:	347-618-9840
Fax Number	:

Authorized Official
Title or Position	:	BILLING MANAGER
Name	:	JENNY RUBIN
Credential	:
Telephone Number	:	718-926-3804

Provider Enumeration Date	:	06/02/2016
Last Update Date	:	06/02/2016

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