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General NPI Number Information
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NPI Number | 1225449507
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Entity Type | Organization
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Legal Business Name | STOCKHOLM OB/GYN SERVICES, PC
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Dates
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Enumeration Date | 05/08/2014
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Last Update Date | 05/08/2014
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Provider Practice Location Address
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Address Line | 93-95 WYCKOFF AVE STOCKHOLM OB/GYN SERVICES, PC
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City | BROOKLYN
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State | NY
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Zip | 11237
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Country | US
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Telephone | 718-486-4155
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Fax |
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Provider Business Mailing Address
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Address Line | 374 STOCKHOLM STREET WYCKOFF HEIGHTS MEDICAL CENTER - FACULTY PRACTICE
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City | BROOKLYN
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State | NY
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Zip | 11237
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Country | US
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Telephone | 718-963-7272
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Fax |
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | FRANK VUTRANO
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Credential |
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Telephone | 718-963-6702
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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