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General NPI Number Information
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NPI Number | 1538698642
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Entity Type | Organization
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Legal Business Name | MEDICAL CARE FOR ALL PC
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Dates
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Enumeration Date | 06/12/2017
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Last Update Date | 06/16/2018
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Provider Practice Location Address
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Address Line | 22 E 41ST ST FL 4
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City | NEW YORK
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State | NY
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Zip | 10017-6280
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Country | US
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Telephone | 212-945-8134
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Fax | 212-558-9131
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Provider Business Mailing Address
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Address Line | 1180 CLOVE RD
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City | STATEN ISLAND
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State | NY
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Zip | 10301-3649
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Country | US
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Telephone | 212-945-8134
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Fax | 888-908-8284
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Authorized Official
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Title or Position | PRESIDENT
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Name | IRINA PETRENKO
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Credential | MD
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Telephone | 212-945-8134
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number |
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207RS0012X
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Taxonomy Name | Sleep Medicine (Internal Medicine) Physician
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License Number |
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License Number State | NY
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