Healthcare Provider Details

I. General information

NPI: 1437458502
Provider Name (Legal Business Name): YELLOW HOOK MEDICAL PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/15/2011
Last Update Date: 04/08/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7601 4TH AVE
BROOKLYN NY
11209-3207
US

IV. Provider business mailing address

7601 4TH AVE
BROOKLYN NY
11209-3207
US

V. Phone/Fax

Practice location:
  • Phone: 718-745-0623
  • Fax: 718-745-8091
Mailing address:
  • Phone: 718-745-0623
  • Fax: 718-745-8091

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. HARRY DEMEO
Title or Position: OWNER
Credential: MD
Phone: 718-745-0623