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General NPI Number Information
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NPI Number | 1285984062
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Entity Type | Organization
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Legal Business Name | LUDMILLA BRONFIN MD LLC
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Dates
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Enumeration Date | 09/19/2012
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Last Update Date | 12/28/2012
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Provider Practice Location Address
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Address Line | 650 FIRST AVENUE 7TH FLOOR
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City | NEW YORK
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State | NY
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Zip | 10016
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Country | US
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Telephone | 212-532-6298
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Fax | 212-532-3308
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Provider Business Mailing Address
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Address Line | 650 FIRST AVENUE 7TH FLOOR
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City | NEW YORK
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State | NY
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Zip | 10016
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Country | US
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Telephone | 212-532-6298
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Fax | 212-532-3308
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Authorized Official
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Title or Position | MANAGER
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Name | DR. LUDMILLA BRONFIN
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Credential | MD
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Telephone | 212-532-6298
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 199889
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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