MEDICARE: COMPASSIONATE MEDICINE, 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	207R00000X	Internal Medicine Physician	223047	NY

General Provider Information

NPI Number	:	1447434667
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMPASSIONATE MEDICINE, P.C.

Provider Business Mailing Address
First Line	:	2345 65TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11204-4045
Country	:	US
Telephone Number	:	718-645-4800
Fax Number	:	718-645-4949

Provider Business Practice Location Address
First Line	:	2345 65TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11204-4045
Country	:	US
Telephone Number	:	718-645-4800
Fax Number	:	718-645-4949

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. INNA PILDYSH
Credential	:	M.D.,D.O.
Telephone Number	:	718-645-4800

Provider Enumeration Date	:	12/24/2007
Last Update Date	:	12/24/2007

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