Healthcare Provider Details

I. General information

NPI: 1184847410
Provider Name (Legal Business Name): PROFESSIONAL GYNECOLOGICAL SERVICES, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/11/2007
Last Update Date: 11/01/2024
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14 DEKALB AVE 2ND FL
BKLYN NY
11201-0000
US

IV. Provider business mailing address

14 DEKALB AVE 2ND FL
BKLYN NY
11201-0000
US

V. Phone/Fax

Practice location:
  • Phone: 929-252-9234
  • Fax:
Mailing address:
  • Phone: 929-252-9234
  • Fax: 929-214-4425

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. DMIETRY BRUNFMAN
Title or Position: OWNER
Credential: MD
Phone: 718-875-4848