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General NPI Number Information
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NPI Number | 1477591907
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Entity Type | Organization
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Legal Business Name | COLON & RECTAL CARE, PC
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Dates
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Enumeration Date | 06/04/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 8405 BAY PKWY
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City | BROOKLYN
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State | NY
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Zip | 11214-3359
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Country | US
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Telephone | 718-236-4040
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Fax | 718-621-1365
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Provider Business Mailing Address
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Address Line | 8405 BAY PKWY
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City | BROOKLYN
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State | NY
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Zip | 11214-3359
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Country | US
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Telephone | 718-236-4040
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Fax | 718-621-1365
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Authorized Official
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Title or Position | PRESIDENT
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Name | BORIS SACHAKOV
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Credential | MD
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Telephone | 718-236-4040
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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