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NPI Code Detail

MEDICARE: CHURCH MEDICAL OFFICES

MEDICARE: CHURCH MEDICAL OFFICES
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
1207Q00000XFamily Medicine Physician

General Provider Information

NPI Number : 1073129557
Entity Type Code : Organization
Provider Name (Legal Business Name) : CHURCH MEDICAL OFFICES
Provider Business Mailing Address
First Line : 1812 CHURCH AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11226-3706
Country : US
Telephone Number : 718-693-9095
Fax Number : 718-693-9095
Provider Business Practice Location Address
First Line : 1812 CHURCH AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11226-3706
Country : US
Telephone Number : 718-693-9095
Fax Number : 718-693-9095
Authorized Official
Title or Position : MEDICAL DIRECTOR
Name : DR. SHELDON SY, MD
Credential : MD
Telephone Number : 570-592-4204
Provider Enumeration Date : 09/19/2020
Last Update Date : 12/24/2020

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Directions to “CHURCH MEDICAL OFFICES ” Practice Location

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