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General NPI Number Information
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NPI Number | 1134323967
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Entity Type | Organization
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Legal Business Name | DOWNTOWN INTEGRATED MEDICAL SERVICES, P.C.
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Dates
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Enumeration Date | 06/14/2007
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Last Update Date | 07/30/2008
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Provider Practice Location Address
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Address Line | 81 WILLOUGHBY ST 4TH FLOOR
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City | BROOKLYN
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State | NY
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Zip | 11201-5291
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Country | US
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Telephone | 718-522-3399
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Fax | 718-522-1888
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Provider Business Mailing Address
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Address Line | 81 WILLOUGHBY ST 4TH FLOOR
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City | BROOKLYN
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State | NY
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Zip | 11201-5291
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Country | US
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Telephone | 718-522-3399
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Fax | 718-522-1888
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Authorized Official
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Title or Position | MEDICAL DOCTOR
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Name | DR. ANZHELA DVORKINA
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Credential | M.D.
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Telephone | 718-522-3399
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 216866
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 206992
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License Number State | NY
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