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General NPI Number Information
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NPI Number | 1174890644
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Entity Type | Organization
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Legal Business Name | ALLERPED MEDICAL PC
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Dates
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Enumeration Date | 11/28/2011
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Last Update Date | 11/28/2011
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Provider Practice Location Address
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Address Line | 2467 OCEAN AVE # 3324455
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City | BROOKLYN
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State | NY
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Zip | 11229-3969
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Country | US
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Telephone | 718-891-2525
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Fax | 718-332-4455
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Provider Business Mailing Address
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Address Line | 2467 OCEAN AVE # 3324455
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City | BROOKLYN
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State | NY
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Zip | 11229-3969
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Country | US
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Telephone | 718-891-2525
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Fax | 718-332-4455
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Authorized Official
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Title or Position | OWNER
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Name | MR. VICTOR KRUPITSKY
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Credential | M.D.
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Telephone | 718-891-2525
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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 | 163702
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License Number State | NY
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