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General NPI Number Information
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NPI Number | 1790949584
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Entity Type | Organization
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Legal Business Name | ACCORD PHYSICIANS, PLLC
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Dates
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Enumeration Date | 07/11/2008
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Last Update Date | 05/28/2015
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Provider Practice Location Address
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Address Line | 2632 E 14TH ST SUITE 101
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City | BROOKLYN
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State | NY
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Zip | 11235-3916
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Country | US
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Telephone | 718-375-2100
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Fax | 718-228-7414
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Provider Business Mailing Address
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Address Line | PO BOX 350822
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City | BROOKLYN
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State | NY
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Zip | 11235-0822
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Country | US
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Telephone | 718-375-2100
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Fax | 718-228-7414
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | DR. VITALY RAYKHMAN
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Credential | M.D.
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Telephone | 718-375-2100
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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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