Healthcare Provider Details

I. General information

NPI: 1205172012
Provider Name (Legal Business Name): APEX MEDICAL MANAGEMENT PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/26/2012
Last Update Date: 12/26/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

668 5TH AVE
BROOKLYN NY
11215-6305
US

IV. Provider business mailing address

668 5TH AVE
BROOKLYN NY
11215-6305
US

V. Phone/Fax

Practice location:
  • Phone: 718-499-4995
  • Fax:
Mailing address:
  • Phone: 718-499-4995
  • Fax:

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: BABURAO DODDAPANENI
Title or Position: DOCTOR
Credential: MD
Phone: 718-499-4995