MEDICARE: NY UNITED HEALTHCARE,LTD

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	207RC0000X	Cardiovascular Disease Physician	237360	NY
2	261QM1300X	Multi-Specialty Clinic/Center

General Provider Information

NPI Number	:	1245285774
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NY UNITED HEALTHCARE,LTD

Provider Business Mailing Address
First Line	:	445 KINGS HIGHWAY
Second Line	:	2 FLOOR
City	:	BROOKLYN
State	:	NY
Zip	:	11223
Country	:	US
Telephone Number	:	718-375-6001
Fax Number	:	718-375-6177

Provider Business Practice Location Address
First Line	:	445 KINGS HWY
Second Line	:	2 FLOOR
City	:	BROOKLYN
State	:	NY
Zip	:	11223-1780
Country	:	US
Telephone Number	:	718-375-6001
Fax Number	:	718-375-6177

Authorized Official
Title or Position	:	MANAGER
Name	:	MR. ELINA SHULMAN
Credential	:
Telephone Number	:	718-375-6001

Provider Enumeration Date	:	05/23/2006
Last Update Date	:	02/24/2017

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