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General NPI Number Information
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NPI Number | 1548211915
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Entity Type | Organization
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Legal Business Name | STAR MEDICAL OFFICES P.C.
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Dates
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Enumeration Date | 05/12/2006
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Last Update Date | 10/04/2007
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Provider Practice Location Address
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Address Line | 415 OCEAN VIEW AVE
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City | BROOKLYN
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State | NY
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Zip | 11235-6828
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Country | US
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Telephone | 718-934-4842
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Fax | 718-616-0165
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Provider Business Mailing Address
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Address Line | 415 OCEAN VIEW AVE
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City | BROOKLYN
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State | NY
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Zip | 11235-6828
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Country | US
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Telephone | 718-934-4842
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Fax | 718-616-0165
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DEMOCLEIA GOTTESMAN
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Credential | MD
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Telephone | 718-934-4842
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 144701
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 181011
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | 203695
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 238025
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License Number State | NY
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Taxonomy #5
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 236385
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License Number State | NY
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Taxonomy #6
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 211150
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License Number State | NY
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