Healthcare Provider Details

I. General information

NPI: 1558416743
Provider Name (Legal Business Name): MEDICAL ARTS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/25/2007
Last Update Date: 06/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

621 GRAVESEND NECK RD
BROOKLYN NY
11223-5126
US

IV. Provider business mailing address

621 GRAVESEND NECK RD
BROOKLYN NY
11223-5126
US

V. Phone/Fax

Practice location:
  • Phone: 718-382-6669
  • Fax:
Mailing address:
  • Phone: 718-382-6669
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number160471
License Number StateNY

VIII. Authorized Official

Name: ZINOVY KATZ
Title or Position: SOLE PROPRIETOR
Credential:
Phone: 718-382-6669