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General NPI Number Information
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NPI Number | 1144590498
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Entity Type | Organization
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Legal Business Name | PROFESSIONAL MEDICAL HEALTHCARE P.C.
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Dates
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Enumeration Date | 01/04/2012
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Last Update Date | 01/04/2012
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Provider Practice Location Address
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Address Line | 5911 16TH AVE
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City | BROOKLYN
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State | NY
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Zip | 11204-2114
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Country | US
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Telephone | 718-645-6434
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Fax |
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Provider Business Mailing Address
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Address Line | 5911 16 AVE
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City | BROOKLYN
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State | NY
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Zip | 11204
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Country | US
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Telephone | 718-645-6434
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. MICHAEL AMOASHIY
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Credential | MD
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Telephone | 718-645-6434
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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 | 211960
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License Number State | NY
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