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General NPI Number Information
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NPI Number | 1124290291
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Entity Type | Organization
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Legal Business Name | ALTAIR MEDICAL PC
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Dates
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Enumeration Date | 03/29/2008
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Last Update Date | 03/22/2023
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Provider Practice Location Address
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Address Line | 1115 OCEAN PKWY STE 1
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City | BROOKLYN
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State | NY
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Zip | 11230-4075
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Country | US
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Telephone | 718-252-5300
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Fax |
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Provider Business Mailing Address
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Address Line | 1615 AVENUE I APT 124
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City | BROOKLYN
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State | NY
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Zip | 11230-3044
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Country | US
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Telephone | 917-705-4047
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | LENNIE HOBENSON
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Credential | D.O.
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Telephone | 917-705-4047
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number | 210050
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License Number State | NY
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