=====================================================
General NPI Number Information
=====================================================
NPI Number | 1659659571
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BAKIR ALTAI MD
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/26/2011
-----------------------------------------------------
Last Update Date | 07/26/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 362 9TH ST
-----------------------------------------------------
City | BROOKLYN
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11215-4008
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 212-444-2209
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 320 7TH AVE
-----------------------------------------------------
City | BROOKLYN
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11215-4194
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 212-444-2209
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PHYSICIAN
-----------------------------------------------------
Name | DR. BAKIR M ALTAI
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 212-444-2209
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208600000X
-----------------------------------------------------
Taxonomy Name | Surgery Physician
-----------------------------------------------------
License Number | 1737871
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------