Healthcare Provider Details

I. General information

NPI: 1588938625
Provider Name (Legal Business Name): B & K MEDICAL ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2012
Last Update Date: 03/07/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1578 WILLIAMSBRIDGE RD
BRONX NY
10461-6265
US

IV. Provider business mailing address

PO BOX 188
TUCKAHOE NY
10707-0188
US

V. Phone/Fax

Practice location:
  • Phone: 718-239-2492
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number205373
License Number StateNY

VIII. Authorized Official

Name: FIRAS BARAKAT
Title or Position: MD
Credential: (718) 239-2492
Phone: 718-239-2492