MEDICARE: A & V MEDICAL ASSOCIATES, P.C.

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	261QM1300X	Multi-Specialty Clinic/Center	231766	NY

General Provider Information

NPI Number	:	1326204512
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	A & V MEDICAL ASSOCIATES, P.C.

Provider Business Mailing Address
First Line	:	1834 ROCKAWAY PKWY
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11236-5006
Country	:	US
Telephone Number	:	718-251-1515
Fax Number	:	718-251-1506

Provider Business Practice Location Address
First Line	:	1834 ROCKAWAY PKWY
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11236-5006
Country	:	US
Telephone Number	:	718-251-1515
Fax Number	:	718-251-1506

Authorized Official
Title or Position	:	DIRECTOR
Name	:	VIDYA M REDDY
Credential	:	M.D.
Telephone Number	:	718-251-1515

Provider Enumeration Date	:	08/06/2008
Last Update Date	:	09/02/2009

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