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General NPI Number Information
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NPI Number | 1447285952
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Entity Type | Organization
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Legal Business Name | PROSPECT HILLS MEDICAL CARE PLLC
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Dates
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Enumeration Date | 07/12/2006
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Last Update Date | 05/08/2013
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Provider Practice Location Address
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Address Line | 275 HULL ST
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City | BROOKLYN
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State | NY
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Zip | 11233-2906
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Country | US
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Telephone | 718-443-2300
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 210968
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City | BROOKLYN
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State | NY
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Zip | 11221-0968
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Country | US
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Telephone | 718-443-2300
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Fax | 718-443-3350
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Authorized Official
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Title or Position | OWNER/CEO
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Name | EMEFRE OSCAR-AMANAM UDO
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Credential | MD
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Telephone | 718-443-2300
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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 | 226995
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License Number State | NY
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