Healthcare Provider Details

I. General information

NPI: 1447302211
Provider Name (Legal Business Name): WEST END MEDICAL PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 W END AVE STE 1
BROOKLYN NY
11235-4812
US

IV. Provider business mailing address

11 W END AVE STE 1
BROOKLYN NY
11235-4812
US

V. Phone/Fax

Practice location:
  • Phone: 718-368-2935
  • Fax: 718-368-0219
Mailing address:
  • Phone: 718-368-2935
  • Fax: 718-368-0219

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204C00000X
TaxonomySports Medicine (Neuromusculoskeletal Medicine) Physician
License Number159570
License Number StateNY

VIII. Authorized Official

Name: INNA LOPATINSKY
Title or Position: DOCTOR
Credential: MD
Phone: 718-368-2935