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NPI Code Detail

MEDICARE: BROOKWELL MEDICAL P.C.

MEDICARE: BROOKWELL MEDICAL 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
1261Q00000XClinic/Center210766NY

General Provider Information

NPI Number : 1619059698
Entity Type Code : Organization
Provider Name (Legal Business Name) : BROOKWELL MEDICAL P.C.
Provider Business Mailing Address
First Line : 1680 OCEAN AVE APT 5K
Second Line :
City : BROOKLYN
State : NY
Zip : 11230-4911
Country : US
Telephone Number : 718-692-3172
Fax Number : 718-692-3172
Provider Business Practice Location Address
First Line : 1680 OCEAN AVE APT 5K
Second Line :
City : BROOKLYN
State : NY
Zip : 11230-4911
Country : US
Telephone Number : 718-692-3172
Fax Number : 718-692-3172
Authorized Official
Title or Position : PRESIDENT
Name : ANATOLY PISMAN
Credential : M.D.
Telephone Number : 718-692-3172
Provider Enumeration Date : 10/19/2006
Last Update Date : 08/22/2020

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Directions to “BROOKWELL MEDICAL P.C. ” Practice Location

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