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General NPI Number Information
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NPI Number | 1669647004
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Entity Type | Organization
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Legal Business Name | MMS MEDICAL
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Dates
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Enumeration Date | 04/28/2008
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Last Update Date | 04/18/2010
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Provider Practice Location Address
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Address Line | 3820 NOSTRAND AVE SUITE 103
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City | BROOKLYN
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State | NY
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Zip | 11235-2000
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Country | US
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Telephone | 718-934-9720
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 350583
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City | BROOKLYN
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State | NY
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Zip | 11235-0583
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Country | US
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Telephone | 718-934-9720
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Fax |
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | PHILIPP PIFKO
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Credential |
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Telephone | 718-934-9720
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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