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General NPI Number Information
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NPI Number | 1477804961
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Entity Type | Organization
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Legal Business Name | S A&D COMPREHENSIVE MEDICAL PC
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Dates
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Enumeration Date | 09/25/2012
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Last Update Date | 09/25/2012
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Provider Practice Location Address
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Address Line | 2000 KINGS HWY STE C
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City | BROOKLYN
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State | NY
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Zip | 11229-1445
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Country | US
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Telephone | 718-787-2077
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Fax | 718-787-2477
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Provider Business Mailing Address
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Address Line | 2000 KINGS HWY, SUITE C
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City | BROOKLYN
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State | NY
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Zip | 11229-1445
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Country | US
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Telephone | 718-787-2077
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Fax | 718-787-2477
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MARINA VINARSKAYA
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Credential | DO
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Telephone | 718-787-2077
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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 | 212557
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License Number State | NY
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