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NPI Code Detail

MEDICARE: E. TWENTE, MD, PC

MEDICARE: E. TWENTE, MD, PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0800XPsychiatry Physician085548NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1003141276
Entity Type Code : Organization
Provider Name (Legal Business Name) : E. TWENTE, MD, PC
Provider Business Mailing Address
First Line : 45 PLAZA ST W
Second Line : APT 2-B
City : BROOKLYN
State : NY
Zip : 11217-3952
Country : US
Telephone Number : 718-622-5796
Fax Number :
Provider Business Practice Location Address
First Line : 45 PLAZA ST W
Second Line : APT 2-B
City : BROOKLYN
State : NY
Zip : 11217-3952
Country : US
Telephone Number : 718-622-5796
Fax Number :
Authorized Official
Title or Position : OWNER
Name : ELMER TWENTE
Credential : M.D.
Telephone Number : 718-622-5796
Provider Enumeration Date : 10/06/2009
Last Update Date : 10/06/2009

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