Healthcare Provider Details

I. General information

NPI: 1033359385
Provider Name (Legal Business Name): APOLLO MEDICAL, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/26/2009
Last Update Date: 02/26/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1340 ROCKAWAY PKWY
BROOKLYN NY
11236-2339
US

IV. Provider business mailing address

1340 ROCKAWAY PKWY
BROOKLYN NY
11236-2339
US

V. Phone/Fax

Practice location:
  • Phone: 718-408-4949
  • Fax: 718-257-0505
Mailing address:
  • Phone: 718-408-4949
  • Fax: 718-257-0505

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number212799
License Number StateNY

VIII. Authorized Official

Name: DR. RAKESH MENON
Title or Position: OWNER
Credential: M.D.
Phone: 718-408-4949