Healthcare Provider Details

I. General information

NPI: 1700466463
Provider Name (Legal Business Name): COLUMBIA MEDICAL CARE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/08/2021
Last Update Date: 04/08/2021
Certification Date: 04/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2965 OCEAN PKWY STE 2A
BROOKLYN NY
11235-8024
US

IV. Provider business mailing address

2965 OCEAN PKWY STE 2A
BROOKLYN NY
11235-8024
US

V. Phone/Fax

Practice location:
  • Phone: 212-596-8888
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: ASHRAF K ABDELHEMID
Title or Position: OWNER
Credential: MD
Phone: 850-730-8585