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NPI Code Detail

MEDICARE: BACK OFFICE MANAGEMENT SERVICES LLC

MEDICARE: BACK OFFICE MANAGEMENT SERVICES 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
1213E00000XPodiatrist

General Provider Information

NPI Number : 1336652585
Entity Type Code : Organization
Provider Name (Legal Business Name) : BACK OFFICE MANAGEMENT SERVICES LLC
Provider Business Mailing Address
First Line : 2802 AVENUE P
Second Line :
City : BROOKLYN
State : NY
Zip : 11229-1810
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1043 BROOKLYN BLVD
Second Line :
City : BEREA
State : KY
Zip : 40403-1090
Country : US
Telephone Number : 718-972-5000
Fax Number :
Authorized Official
Title or Position : OWNER
Name : ALAN R TAJERSTEIN
Credential :
Telephone Number : 718-972-5000
Provider Enumeration Date : 11/09/2017
Last Update Date : 11/09/2017

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Directions to “BACK OFFICE MANAGEMENT SERVICES LLC ” Practice Location

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