MEDICARE: PRISTINE MEDICAL CARE 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
2	208000000X	Pediatrics Physician

General Provider Information

NPI Number	:	1598796245
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRISTINE MEDICAL CARE PLLC

Provider Business Mailing Address
First Line	:	7209 16TH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11204-5106
Country	:	US
Telephone Number	:	718-975-0068
Fax Number	:	718-975-0104

Provider Business Practice Location Address
First Line	:	7209 16TH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11204-5106
Country	:	US
Telephone Number	:	718-975-0068
Fax Number	:	718-975-0104

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MIN A WONG
Credential	:	MD
Telephone Number	:	718-975-0068

Provider Enumeration Date	:	07/05/2006
Last Update Date	:	09/11/2025

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