MEDICARE: SMS MEDICAL CARE, P.C.

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	2084P0800X	Psychiatry Physician

General Provider Information

NPI Number	:	1346748845
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SMS MEDICAL CARE, P.C.

Provider Business Mailing Address
First Line	:	801 AVENUE C APT 3A
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11218-4241
Country	:	US
Telephone Number	:	646-409-4720
Fax Number	:

Provider Business Practice Location Address
First Line	:	486 MCDONALD AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11218-3812
Country	:	US
Telephone Number	:	718-247-7226
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT/PROVIDER
Name	:	DR. SOHAL MUHAMMED SHIPU
Credential	:	MD
Telephone Number	:	646-409-4720

Provider Enumeration Date	:	01/30/2018
Last Update Date	:	03/17/2018

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