Healthcare Provider Details

I. General information

NPI: 1487289013
Provider Name (Legal Business Name): METRO HEALTHCARE PARTNERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/04/2020
Last Update Date: 09/09/2021
Certification Date: 09/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3500 NOSTRAND AVE
BROOKLYN NY
11229-5107
US

IV. Provider business mailing address

3500 NOSTRAND AVE
BROOKLYN NY
11229-5107
US

V. Phone/Fax

Practice location:
  • Phone: 718-769-2521
  • Fax: 718-228-6839
Mailing address:
  • Phone: 718-769-2521
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MRS. DEBORAH L HEATHERLY
Title or Position: BILLER
Credential:
Phone: 347-933-6740