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General NPI Number Information
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NPI Number | 1467515767
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Entity Type | Organization
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Legal Business Name | BAY PARKWAY PHYSICIANS, PC
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Dates
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Enumeration Date | 12/18/2006
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Last Update Date | 03/24/2008
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Provider Practice Location Address
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Address Line | 6417 BAY PKWY
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City | BROOKLYN
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State | NY
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Zip | 11204-3930
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Country | US
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Telephone | 718-234-6767
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Fax | 718-234-0994
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Provider Business Mailing Address
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Address Line | 6417 BAY PKWY
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City | BROOKLYN
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State | NY
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Zip | 11204-3930
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Country | US
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Telephone | 718-234-6767
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Fax | 718-234-0994
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | MICHAEL PATIN
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Credential |
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Telephone | 718-234-6767
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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 |
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License Number State |
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