MEDICARE: OCEAN BREEZE 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	207R00000X	Internal Medicine Physician	1981431	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1700805876
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OCEAN BREEZE MEDICAL P.C.

Provider Business Mailing Address
First Line	:	3111 OCEAN PKWY
Second Line	:	APT 7B
City	:	BROOKLYN
State	:	NY
Zip	:	11235-8400
Country	:	US
Telephone Number	:	718-332-7916
Fax Number	:	718-332-7918

Provider Business Practice Location Address
First Line	:	2965 OCEAN PKWY
Second Line	:	SUITE 304
City	:	BROOKLYN
State	:	NY
Zip	:	11235-8014
Country	:	US
Telephone Number	:	718-332-7916
Fax Number	:	718-332-7918

Authorized Official
Title or Position	:	DOCTOR
Name	:	DR. ALEXANDER SHEKHTER
Credential	:	M.D.
Telephone Number	:	718-332-7916

Provider Enumeration Date	:	07/19/2006
Last Update Date	:	06/28/2011

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Directions to “OCEAN BREEZE MEDICAL P.C. ” Practice Location

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