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NPI Code Detail

MEDICARE: UNIQUE SURGICAL PAVILION LLC

MEDICARE: UNIQUE SURGICAL PAVILION LLC
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
1261QA1903XAmbulatory Surgical Clinic/CenterNY

General Provider Information

NPI Number : 1184074361
Entity Type Code : Organization
Provider Name (Legal Business Name) : UNIQUE SURGICAL PAVILION LLC
Provider Business Mailing Address
First Line : 852 E 7TH ST APT 7B
Second Line :
City : BROOKLYN
State : NY
Zip : 11230-2287
Country : US
Telephone Number : 347-252-6732
Fax Number : 347-252-6731
Provider Business Practice Location Address
First Line : 369 LEXINGTON AVE STE 800
Second Line :
City : NEW YORK
State : NY
Zip : 10017-6506
Country : US
Telephone Number : 347-252-6732
Fax Number : 347-252-6731
Authorized Official
Title or Position : DIRECTOR
Name : DR. MILA MOGILEVSKY
Credential : D.O
Telephone Number : 347-252-6732
Provider Enumeration Date : 06/17/2016
Last Update Date : 06/17/2016

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Directions to “UNIQUE SURGICAL PAVILION LLC ” Practice Location

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