Healthcare Provider Details

I. General information

NPI: 1417030883
Provider Name (Legal Business Name): HOWARD MITCHELL ORKIN M.D..
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/21/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8605 FLATLANDS AVE
BROOKLYN NY
11236-3607
US

IV. Provider business mailing address

8605 FLATLANDS AVE
BROOKLYN NY
11236-3607
US

V. Phone/Fax

Practice location:
  • Phone: 718-257-1500
  • Fax:
Mailing address:
  • Phone: 718-257-1500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License Number148629
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: