Healthcare Provider Details

I. General information

NPI: 1144235516
Provider Name (Legal Business Name): INTERMED CARE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2006
Last Update Date: 05/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3048 BRIGHTON 1ST ST
BROOKLYN NY
11235-8080
US

IV. Provider business mailing address

1849 86TH ST
BROOKLYN NY
11214-3108
US

V. Phone/Fax

Practice location:
  • Phone: 718-368-1170
  • Fax: 718-368-2342
Mailing address:
  • Phone: 718-331-9600
  • Fax: 718-331-9703

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number
License Number State

VIII. Authorized Official

Name: ALEC RUBINS
Title or Position: OFFICE MANAGER
Credential:
Phone: 718-368-1170