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General NPI Number Information
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NPI Number | 1326204512
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Entity Type | Organization
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Legal Business Name | A & V MEDICAL ASSOCIATES, P.C.
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Dates
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Enumeration Date | 08/06/2008
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Last Update Date | 09/02/2009
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Provider Practice Location Address
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Address Line | 1834 ROCKAWAY PKWY
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City | BROOKLYN
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State | NY
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Zip | 11236-5006
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Country | US
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Telephone | 718-251-1515
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Fax | 718-251-1506
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Provider Business Mailing Address
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Address Line | 1834 ROCKAWAY PKWY
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City | BROOKLYN
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State | NY
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Zip | 11236-5006
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Country | US
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Telephone | 718-251-1515
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Fax | 718-251-1506
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Authorized Official
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Title or Position | DIRECTOR
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Name | VIDYA M REDDY
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Credential | M.D.
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Telephone | 718-251-1515
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number | 231766
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License Number State | NY
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