Healthcare Provider Details

I. General information

NPI: 1003085051
Provider Name (Legal Business Name): SYNERGY FIRST MEDICAL PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/25/2008
Last Update Date: 02/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1575 E 19TH ST
BROOKLYN NY
11230-7203
US

IV. Provider business mailing address

1575 E 19TH ST
BROOKLYN NY
11230-7203
US

V. Phone/Fax

Practice location:
  • Phone: 718-748-5300
  • Fax: 718-748-0920
Mailing address:
  • Phone: 718-748-5300
  • Fax: 718-748-0920

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JEFFREY BENZVI
Title or Position: DIRECTOR
Credential: M.D.
Phone: 718-742-5300