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NPI Code Detail

MEDICARE: BROOKLYN RADIATION ONCOLOGY PC

MEDICARE: BROOKLYN RADIATION ONCOLOGY 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
1207RH0003XHematology & Oncology Physician
2208600000XSurgery Physician
3208800000XUrology Physician
4208C00000XColon & Rectal Surgery Physician
52085R0001XRadiation Oncology Physician

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2DF6854OTHERNYRR MEDICARE

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 : 1033163506
Entity Type Code : Organization
Provider Name (Legal Business Name) : BROOKLYN RADIATION ONCOLOGY PC
Provider Business Mailing Address
First Line : PO BOX 6054
Second Line :
City : SPRING HILL
State : FL
Zip : 34611-6054
Country : US
Telephone Number : 917-688-2534
Fax Number : 800-420-3318
Provider Business Practice Location Address
First Line : 2101 AVENUE X
Second Line :
City : BROOKLYN
State : NY
Zip : 11235-2910
Country : US
Telephone Number : 718-517-2900
Fax Number : 800-420-3318
Authorized Official
Title or Position : MD,CEO
Name : LESLIE BOTNICK
Credential : MD
Telephone Number : 310-335-4067
Provider Enumeration Date : 05/20/2006
Last Update Date : 10/09/2023

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Directions to “BROOKLYN RADIATION ONCOLOGY PC ” Practice Location

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