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NPI Code Detail

MEDICARE: NORTHSIDE MEDICAL CARE LLP

MEDICARE: NORTHSIDE MEDICAL CARE LLP
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
1207R00000XInternal Medicine Physician186518NY

General Provider Information

NPI Number : 1659493179
Entity Type Code : Organization
Provider Name (Legal Business Name) : NORTHSIDE MEDICAL CARE LLP
Provider Business Mailing Address
First Line : 66 NASSAU AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11222-3105
Country : US
Telephone Number : 718-383-4600
Fax Number : 718-389-7393
Provider Business Practice Location Address
First Line : 66 NASSAU AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11222-3105
Country : US
Telephone Number : 718-383-4600
Fax Number : 718-389-7393
Authorized Official
Title or Position : OWNER
Name : DR. ARTHUR AUTZ
Credential : M.D.
Telephone Number : 718-383-4600
Provider Enumeration Date : 04/04/2007
Last Update Date : 10/01/2008

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Directions to “NORTHSIDE MEDICAL CARE LLP ” Practice Location

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