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General NPI Number Information
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NPI Number | 1750529541
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Entity Type | Organization
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Legal Business Name | PRILIK MEDICAL PC
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Dates
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Enumeration Date | 02/02/2009
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Last Update Date | 02/02/2009
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Provider Practice Location Address
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Address Line | 926 EILEEN TER
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City | WOODMERE
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State | NY
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Zip | 11598-1519
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Country | US
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Telephone | 917-783-9292
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Fax | 718-228-8414
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Provider Business Mailing Address
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Address Line | 926 EILEEN TER
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City | WOODMERE
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State | NY
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Zip | 11598-1519
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Country | US
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Telephone | 917-783-9292
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Fax | 718-228-8414
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | SOFIYA PRILIK
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Credential | M.D.
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Telephone | 917-783-9292
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 239234
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License Number State | NY
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