Healthcare Provider Details

I. General information

NPI: 1679677280
Provider Name (Legal Business Name): AVE X MEDICAL TESTING CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2006
Last Update Date: 12/01/2025
Certification Date: 12/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 AVENUE X
BROOKLYN NY
11223
US

IV. Provider business mailing address

2727 CONEY ISLAND AVE STE 1B
BROOKLYN NY
11235-5004
US

V. Phone/Fax

Practice location:
  • Phone: 718-376-6500
  • Fax: 718-376-5078
Mailing address:
  • Phone: 718-376-6500
  • Fax: 718-376-5078

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LEV PAUKMAN
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 718-376-6500