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General NPI Number Information
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NPI Number | 1598924458
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Entity Type | Organization
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Legal Business Name | MANHATTAN BEACH OBGYN, P.C.
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Dates
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Enumeration Date | 06/05/2008
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Last Update Date | 07/13/2010
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Provider Practice Location Address
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Address Line | 3047 BRIGHTON 6TH ST SUITE 1
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City | BROOKLYN
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State | NY
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Zip | 11235
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Country | US
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Telephone | 718-743-7877
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Fax | 718-743-4870
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Provider Business Mailing Address
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Address Line | P.O. BOX 350-278
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City | BROOKLYN
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State | NY
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Zip | 11235
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Country | US
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Telephone | 718-743-7877
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Fax | 718-743-4870
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DMITRIY BRONFMAN
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Credential | MD
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Telephone | 718-743-7877
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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