Healthcare Provider Details

I. General information

NPI: 1508959743
Provider Name (Legal Business Name): TBHC MEDICAL SERVICES, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 05/01/2025
Certification Date: 05/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 DEKALB AVENUE
BROOKLYN NY
11201
US

IV. Provider business mailing address

PO BOX 13567
PHILADELPHIA PA
19101-3567
US

V. Phone/Fax

Practice location:
  • Phone: 718-250-8621
  • Fax: 718-250-8878
Mailing address:
  • Phone: 718-250-8621
  • Fax: 718-250-8878

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: SAM AMIRFAR
Title or Position: OWNER, AUTHORIZED SIGNATORY
Credential: MD
Phone: 718-250-6813