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NPI Code Detail

MEDICARE: OZONE PARK MEDICAL CARE PLLC

MEDICARE: OZONE PARK MEDICAL CARE 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
1207R00000XInternal Medicine Physician230021NY

General Provider Information

NPI Number : 1518203280
Entity Type Code : Organization
Provider Name (Legal Business Name) : OZONE PARK MEDICAL CARE PLLC
Provider Business Mailing Address
First Line : 1219 LIBERTY AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11208-3411
Country : US
Telephone Number : 718-235-4700
Fax Number :
Provider Business Practice Location Address
First Line : 1219 LIBERTY AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11208-3411
Country : US
Telephone Number : 718-235-4700
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : DR. MOHAMMAD MOMINUR RAHMAN
Credential : MD
Telephone Number : 718-235-4700
Provider Enumeration Date : 12/27/2012
Last Update Date : 01/07/2013

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Directions to “OZONE PARK MEDICAL CARE PLLC ” Practice Location

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