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General NPI Number Information
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NPI Number | 1891664140
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Entity Type | Organization
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Legal Business Name | ADVANCED WOUND CARE LLC
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Dates
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Enumeration Date | 11/04/2025
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Last Update Date | 11/04/2025
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Provider Practice Location Address
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Address Line | 6915 YELLOWSTONE BLVD STE 4
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City | FOREST HILLS
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State | NY
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Zip | 11375-3787
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Country | US
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Telephone | 212-991-9991
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Fax | 212-991-9901
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Provider Business Mailing Address
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Address Line | 6915 YELLOWSTONE BLVD STE 4
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City | FOREST HILLS
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State | NY
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Zip | 11375-3787
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Country | US
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Telephone | 212-991-9991
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Fax | 718-991-9901
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Authorized Official
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Title or Position | OWNER
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Name | DAVID SHUSTERMAN
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Credential | MD
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Telephone | 212-991-9991
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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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