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General NPI Number Information
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NPI Number | 1528250347
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Entity Type | Organization
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Legal Business Name | ALEKSANDR LIVSHITS MEDICAL, PC
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Dates
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Enumeration Date | 08/15/2007
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Last Update Date | 08/15/2007
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Provider Practice Location Address
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Address Line | 445 KINGS HWY STE 2
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City | BROOKLYN
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State | NY
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Zip | 11223-1780
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Country | US
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Telephone | 718-645-0300
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Fax | 718-375-5920
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Provider Business Mailing Address
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Address Line | 445 KINGS HWY STE 2
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City | BROOKLYN
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State | NY
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Zip | 11223-1780
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Country | US
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Telephone | 718-645-0300
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Fax | 718-375-5920
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Authorized Official
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Title or Position | GENERAL MANAGER
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Name | ELINA SHULMAN
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Credential | RN
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Telephone | 718-375-6001
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 201746
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License Number State | NY
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