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General NPI Number Information
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NPI Number | 1144235516
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Entity Type | Organization
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Legal Business Name | INTERMED CARE PC
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Dates
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Enumeration Date | 07/31/2006
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Last Update Date | 05/22/2019
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Provider Practice Location Address
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Address Line | 3048 BRIGHTON 1ST ST
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City | BROOKLYN
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State | NY
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Zip | 11235-8080
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Country | US
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Telephone | 718-368-1170
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Fax | 718-368-2342
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Provider Business Mailing Address
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Address Line | 1849 86TH ST
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City | BROOKLYN
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State | NY
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Zip | 11214-3108
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Country | US
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Telephone | 718-331-9600
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Fax | 718-331-9703
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | ALEC RUBINS
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Credential |
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Telephone | 718-368-1170
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 173000000X
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Taxonomy Name | Legal Medicine
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License Number |
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License Number State |
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