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General NPI Number Information
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NPI Number | 1639438492
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Entity Type | Organization
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Legal Business Name | E H RELIABLE MEDICAL PC
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Dates
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Enumeration Date | 05/14/2012
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Last Update Date | 01/04/2019
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Provider Practice Location Address
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Address Line | 1946 BATH AVE
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City | BROOKLYN
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State | NY
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Zip | 11214
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Country | US
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Telephone | 718-996-7460
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Fax | 718-996-7461
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Provider Business Mailing Address
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Address Line | 1946 BATH AVE
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City | BROOKLYN
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State | NY
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Zip | 11214-4704
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Country | US
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Telephone | 718-996-7460
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Fax | 718-996-7461
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ELSAYED H ELDEEB
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Credential | MD
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Telephone | 718-833-7466
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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 | 262324
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License Number State | NY
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