MEDICARE: 1578 MEDICAL HEALTHCARE 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

General Provider Information

NPI Number	:	1497634513
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	1578 MEDICAL HEALTHCARE P.C.

Provider Business Mailing Address
First Line	:	PO BOX 70801A
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11207-0925
Country	:	US
Telephone Number	:	516-697-3799
Fax Number	:

Provider Business Practice Location Address
First Line	:	1578 WILLIAMSBRIDGE RD STE 2D
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10461-6266
Country	:	US
Telephone Number	:	718-360-5548
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. KAMAL TADROS
Credential	:	MD
Telephone Number	:	516-697-3799

Provider Enumeration Date	:	09/02/2025
Last Update Date	:	09/02/2025

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