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General NPI Number Information
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NPI Number | 1285141358
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Entity Type | Organization
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Legal Business Name | NIE MEDICAL OFFICE PC
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Dates
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Enumeration Date | 01/10/2018
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Last Update Date | 01/10/2018
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Provider Practice Location Address
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Address Line | 5508 7TH AVENUE 1ST FLOOR
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City | BROOKLYN
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State | NY
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Zip | 11220-3508
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Country | US
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Telephone | 718-865-8364
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Fax | 718-871-2516
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Provider Business Mailing Address
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Address Line | 5508 7TH AVENUE 1ST FLOOR
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City | BROOKLYN
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State | NY
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Zip | 11220-3508
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Country | US
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Telephone | 718-865-8364
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Fax | 718-871-2516
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Authorized Official
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Title or Position | OFFICER
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Name | GUO NIE
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Credential | M.D.
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Telephone | 718-708-9611
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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 |
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License Number State |
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