Healthcare Provider Details
I. General information
NPI: 1386580710
Provider Name (Legal Business Name): BIO MEDICINE CHECK GA PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
250 SKILLMAN ST STE 204
BROOKLYN NY
11205-1218
US
IV. Provider business mailing address
250 SKILLMAN ST STE 204
BROOKLYN NY
11205-1218
US
V. Phone/Fax
- Phone: 212-734-6621
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ELAZAR
SOFER
Title or Position: OWNER
Credential:
Phone: 212-734-6621