MEDICARE: ENABLE MEDICAL PLLC

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	207RC0000X	Cardiovascular Disease Physician

General Provider Information

NPI Number	:	1437814241
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ENABLE MEDICAL PLLC

Provider Business Mailing Address
First Line	:	540 MCDONALD AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11218-3823
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	540 MCDONALD AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11218-3823
Country	:	US
Telephone Number	:	347-868-0325
Fax Number	:

Authorized Official
Title or Position	:	FOUNDER
Name	:	BETHANY DORAN
Credential	:	MD/MPH
Telephone Number	:	347-868-0325

Provider Enumeration Date	:	11/05/2021
Last Update Date	:	11/05/2021

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