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General NPI Number Information
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NPI Number | 1235460718
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Entity Type | Organization
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Legal Business Name | ALL HEALTHY STYLE MEDICAL PC
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Dates
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Enumeration Date | 01/22/2010
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Last Update Date | 01/25/2010
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Provider Practice Location Address
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Address Line | 522 LEFFERTS AVE OFFICE C
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City | BROOKLYN
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State | NY
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Zip | 11225-4597
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Country | US
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Telephone | 347-787-1020
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Fax |
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Provider Business Mailing Address
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Address Line | 522 LEFFERTS AVE OFFICE C
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City | BROOKLYN
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State | NY
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Zip | 11225-4597
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Country | US
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Telephone | 347-787-1020
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BORIS RIPA
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Credential | M.D.
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Telephone | 347-787-1020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 207307
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License Number State | NY
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