Healthcare Provider Details
I. General information
NPI: 1972826352
Provider Name (Legal Business Name): HEALTHVIEW MEDICAL PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/12/2010
Last Update Date: 03/12/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
121 GRAHAM AVE
BROOKLYN NY
11206-2609
US
IV. Provider business mailing address
121 GRAHAM AVE
BROOKLYN NY
11206-2609
US
V. Phone/Fax
- Phone: 718-963-0276
- Fax: 718-963-0277
- Phone: 718-963-0276
- Fax: 718-963-0277
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207QA0505X |
| Taxonomy | Adult Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DAVID
B
HERSHAN
Title or Position: OFFICER
Credential: M.D
Phone: 718-963-0276