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NPI Code Detail

MEDICARE: A & E MEDICAL

MEDICARE: A & E MEDICAL
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
12085R0204XVascular & Interventional Radiology Physician

General Provider Information

NPI Number : 1528674611
Entity Type Code : Organization
Provider Name (Legal Business Name) : A & E MEDICAL
Provider Business Mailing Address
First Line : 120 HICKSVILLE RD
Second Line :
City : BETHPAGE
State : NY
Zip : 11714-3443
Country : US
Telephone Number : 516-717-1839
Fax Number :
Provider Business Practice Location Address
First Line : 2174 FLATBUSH AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11234-4326
Country : US
Telephone Number : 516-717-1839
Fax Number :
Authorized Official
Title or Position : MEDICAL DIRECTOR
Name : ABRAHAM KNOLL
Credential : MD
Telephone Number : 516-717-1887
Provider Enumeration Date : 09/23/2020
Last Update Date : 11/23/2021

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Directions to “A & E MEDICAL ” Practice Location

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