MEDICARE: USA MEDICAL OF BENSONHURST LLC

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	2427581	NY

General Provider Information

NPI Number	:	1780028597
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	USA MEDICAL OF BENSONHURST LLC

Provider Business Mailing Address
First Line	:	2444 86TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11214-4415
Country	:	US
Telephone Number	:	718-709-5329
Fax Number	:

Provider Business Practice Location Address
First Line	:	2444 86TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11214-4415
Country	:	US
Telephone Number	:	718-709-5329
Fax Number	:

Authorized Official
Title or Position	:	SOLE OWNER
Name	:	DR. FLORA KATSNELSON
Credential	:	MD
Telephone Number	:	847-305-3346

Provider Enumeration Date	:	04/23/2013
Last Update Date	:	04/23/2013

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