Healthcare Provider Details
I. General information
NPI: 1437567690
Provider Name (Legal Business Name): GENTLE TOUCH MEDICAL PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/31/2014
Last Update Date: 07/31/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9708 SEAVIEW AVE
BROOKLYN NY
11236-5516
US
IV. Provider business mailing address
9708 SEAVIEW AVE
BROOKLYN NY
11236-5516
US
V. Phone/Fax
- Phone: 718-444-0520
- Fax: 718-444-1898
- Phone: 718-444-0520
- Fax: 718-444-1898
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
RIMMA
POZDNYAKOVA
Title or Position: PRESIDENT
Credential: M.D.
Phone: 718-444-0520