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General NPI Number Information
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NPI Number | 1467620237
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Entity Type | Organization
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Legal Business Name | NORTHSTAR MEDICAL PLLC
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Dates
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Enumeration Date | 02/14/2008
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Last Update Date | 02/14/2008
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Provider Practice Location Address
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Address Line | 101 24 QUEENS BLVD SUITE A
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City | FOREST HILLS
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State | NY
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Zip | 11375
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Country | US
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Telephone | 718-275-2788
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Fax | 718-275-2789
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Provider Business Mailing Address
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Address Line | 1408 OCEAN AVE 3RD FLOOR
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City | BROOKLYN
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State | NY
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Zip | 11230-3814
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Country | US
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Telephone | 718-338-0909
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Fax | 718-252-5011
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. PAUL ACKERMAN
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Credential | MD
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Telephone | 718-338-0909
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 38812
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License Number State | NY
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