Healthcare Provider Details

I. General information

NPI: 1013173541
Provider Name (Legal Business Name): HARLEM MEDICAL CARE P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2008
Last Update Date: 05/16/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2860 OCEAN AVE SUITE A1
BROOKLYN NY
11235-3166
US

IV. Provider business mailing address

2860 OCEAN AVE SUITE A1
BROOKLYN NY
11235-3166
US

V. Phone/Fax

Practice location:
  • Phone: 718-753-2223
  • Fax: 718-872-7509
Mailing address:
  • Phone: 718-753-2223
  • Fax: 718-872-7509

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number236807-1
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number236807
License Number StateNY

VIII. Authorized Official

Name: MR. MARK MICHNIK
Title or Position: OWNER
Credential: M.D.
Phone: 917-907-2983