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General NPI Number Information
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NPI Number | 1407877574
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Entity Type | Organization
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Legal Business Name | HILLSIDE ADVANCED MEDICAL P.C.
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Dates
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Enumeration Date | 07/22/2006
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Last Update Date | 12/12/2012
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Provider Practice Location Address
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Address Line | 401 OCEAN VIEW AVE
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City | BROOKLYN
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State | NY
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Zip | 11235-6828
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Country | US
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Telephone | 718-332-7551
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Fax | 718-332-6385
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Provider Business Mailing Address
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Address Line | 401 OCEAN VIEW AVE LEVEL C
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City | BROOKLYN
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State | NY
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Zip | 11235-6828
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Country | US
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Telephone | 718-332-7551
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Fax | 718-332-6385
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MARAT TSIRLIN
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Credential | M.D.
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Telephone | 718-332-7551
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 203451
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License Number State | NY
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