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General NPI Number Information
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NPI Number | 1265852800
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Entity Type | Organization
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Legal Business Name | IMMEDIATE CARE MEDICAL WALK-IN OF BENSONHURST, PC
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Dates
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Enumeration Date | 04/22/2014
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Last Update Date | 03/16/2015
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Provider Practice Location Address
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Address Line | 6906 18TH AVE
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City | BROOKLYN
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State | NY
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Zip | 11204-5048
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Country | US
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Telephone | 732-335-9400
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Fax |
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Provider Business Mailing Address
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Address Line | 6906 18TH AVE
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City | BROOKLYN
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State | NY
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Zip | 11204-5048
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CHIEF MEDICAL OFFICER
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Name | DR. ESMAT SHAROBEEM
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Credential | M.D.
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Telephone | 732-335-9400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State | NY
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