MEDICARE: DOCTOR'S 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
1	174400000X	Specialist	199870-4	NY

General Provider Information

NPI Number	:	1619362803
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DOCTOR'S MEDICAL P.C

Provider Business Mailing Address
First Line	:	2968 AVENUE X
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11235-1808
Country	:	US
Telephone Number	:	718-769-4988
Fax Number	:	718-769-4415

Provider Business Practice Location Address
First Line	:	2968 AVENUE X
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11235-1808
Country	:	US
Telephone Number	:	718-769-4988
Fax Number	:	718-769-4415

Authorized Official
Title or Position	:	CEO
Name	:	DR. AHMED E ELEMAM
Credential	:	MD
Telephone Number	:	718-769-4988

Provider Enumeration Date	:	04/03/2015
Last Update Date	:	04/08/2015

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