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NPI Code Detail

MEDICARE: DR. IGOR SHORMAN M.D

MEDICARE: DR. IGOR SHORMAN 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
1208000000XPediatrics Physician254070NY

General Provider Information

NPI Number : 1306076245
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. IGOR SHORMAN M.D
Provider Business Mailing Address
First Line : 1407 W 6TH ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11204-4802
Country : US
Telephone Number : 718-236-6994
Fax Number : 718-331-3871
Provider Business Practice Location Address
First Line : 1407 W 6TH ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11204-4802
Country : US
Telephone Number : 718-236-6994
Fax Number : 718-331-3871
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/24/2009
Last Update Date : 07/24/2009

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Directions to “ DR. IGOR SHORMAN M.D” Practice Location

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