MEDICARE: FRONTLINE MEDICAL PC

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	:	1316687239
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FRONTLINE MEDICAL PC

Provider Business Mailing Address
First Line	:	1573 E 22ND ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11210-5109
Country	:	US
Telephone Number	:	917-415-5147
Fax Number	:

Provider Business Practice Location Address
First Line	:	1573 E 22ND ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11210-5109
Country	:	US
Telephone Number	:	917-415-5147
Fax Number	:

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	ELI INZLICHT -SPREI
Credential	:	MD
Telephone Number	:	917-415-5147

Provider Enumeration Date	:	03/30/2022
Last Update Date	:	02/12/2026

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