Healthcare Provider Details

I. General information

NPI: 1154627842
Provider Name (Legal Business Name): VISITING MEDICAL DOCTORS OF N.Y. P.L.L.C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/28/2011
Last Update Date: 01/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3057 CONEY ISLAND AVE
BROOKLYN NY
11235-6320
US

IV. Provider business mailing address

1663 E 18TH ST
BROOKLYN NY
11229-1257
US

V. Phone/Fax

Practice location:
  • Phone: 718-951-0500
  • Fax:
Mailing address:
  • Phone: 718-436-3211
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD 162525
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207RI0001X
TaxonomyClinical & Laboratory Immunology (Internal Medicine) Physician
License NumberMD 150519
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberMD 123999
License Number StateNY

VIII. Authorized Official

Name: DR. JOEL M ARBISSER
Title or Position: MEMBER
Credential: M.D.
Phone: 17184363211