Healthcare Provider Details

I. General information

NPI: 1356489173
Provider Name (Legal Business Name): RIM MEDICAL PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/02/2007
Last Update Date: 09/27/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2818 OCEAN AVE STE 1
BROOKLYN NY
11235-3170
US

IV. Provider business mailing address

2818 OCEAN AVE STE 1
BROOKLYN NY
11235-3170
US

V. Phone/Fax

Practice location:
  • Phone: 718-934-8484
  • Fax: 718-934-4267
Mailing address:
  • Phone: 718-934-8484
  • Fax: 718-934-4267

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. MICHAEL RISKEVICH
Title or Position: MANAGER
Credential: M.D., D.O
Phone: 718-934-8484