Healthcare Provider Details

I. General information

NPI: 1720093420
Provider Name (Legal Business Name): ADVANCED FAMILY MEDICAL CARE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2006
Last Update Date: 01/06/2025
Certification Date: 01/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

618 AVENUE H STE C1
BROOKLYN NY
11230-2294
US

IV. Provider business mailing address

618 AVENUE H APT C1
BROOKLYN NY
11230-2294
US

V. Phone/Fax

Practice location:
  • Phone: 718-253-9110
  • Fax: 718-253-0767
Mailing address:
  • Phone: 718-253-9110
  • Fax: 718-253-0767

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number219277
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: HELEN ZELMO
Title or Position: CRED
Credential:
Phone: 917-731-3008