MEDICARE: BROOKLYN CARE 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	226140	NY

General Provider Information

NPI Number	:	1568668119
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BROOKLYN CARE MEDICAL PC

Provider Business Mailing Address
First Line	:	1725 E 12TH ST
Second Line	:	SUITE 201
City	:	BROOKLYN
State	:	NY
Zip	:	11229-1028
Country	:	US
Telephone Number	:	718-790-0744
Fax Number	:

Provider Business Practice Location Address
First Line	:	1725 E 12TH ST
Second Line	:	SUITE 201
City	:	BROOKLYN
State	:	NY
Zip	:	11229-1028
Country	:	US
Telephone Number	:	718-790-0744
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. MARK AZBEL
Credential	:	MD
Telephone Number	:	718-790-0744

Provider Enumeration Date	:	06/21/2007
Last Update Date	:	08/22/2020

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