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General NPI Number Information
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NPI Number | 1770615064
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Entity Type | Individual
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Provider Name | MATVEY BROKHIN MD
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Gender | Male
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Dates
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Enumeration Date | 03/12/2007
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Last Update Date | 08/03/2011
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Provider Practice Location Address
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Address Line | 3131 KINGS HWY STE B10
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City | BROOKLYN
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State | NY
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Zip | 11234-2643
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Country | US
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Telephone | 347-462-9292
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Fax |
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Provider Business Mailing Address
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Address Line | 3131 KINGS HWY STE B10
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City | BROOKLYN
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State | NY
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Zip | 11234-2643
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Country | US
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Telephone | 646-500-2160
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | 25MA08454800
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 25MA08454800
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | 232962
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License Number State | NY
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