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NPI Code Detail

MEDICARE: MILLENNIUM MEDICAL SERVICES, PC

MEDICARE: MILLENNIUM MEDICAL SERVICES, 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
1207Q00000XFamily Medicine Physician

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1CF8730OTHERNYRAILROAD MEDICARE

General Provider Information

NPI Number : 1184609802
Entity Type Code : Organization
Provider Name (Legal Business Name) : MILLENNIUM MEDICAL SERVICES, PC
Provider Business Mailing Address
First Line : 7400 18TH AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11204-5612
Country : US
Telephone Number : 718-236-9446
Fax Number : 718-236-3854
Provider Business Practice Location Address
First Line : 7400 18TH AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11204-5612
Country : US
Telephone Number : 718-236-9446
Fax Number : 718-236-3854
Authorized Official
Title or Position : CFO, DIRECTOR OF OPERATIONS
Name : MRS. LORETTA MARIA VENTO
Credential :
Telephone Number : 718-236-9446
Provider Enumeration Date : 12/15/2005
Last Update Date : 07/05/2010

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Directions to “MILLENNIUM MEDICAL SERVICES, PC ” Practice Location

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