MEDICARE: DR. MIKHAIL MAKHLIN M.D.

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
1	207RG0300X	Geriatric Medicine (Internal Medicine) Physician	207258	NY

General Provider Information

NPI Number	:	1215039839
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MIKHAIL MAKHLIN M.D.

Provider Business Mailing Address
First Line	:	112 72ND ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11209-1902
Country	:	US
Telephone Number	:	718-265-9130
Fax Number	:	718-372-4339

Provider Business Practice Location Address
First Line	:	112 72ND ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11209-1902
Country	:	US
Telephone Number	:	718-265-9130
Fax Number	:	718-372-4339

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/03/2006
Last Update Date	:	07/08/2007

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