MEDICARE: EPS MEDICAL, PC

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	207Q00000X	Family Medicine Physician	224376	NY

General Provider Information

NPI Number	:	1568898815
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EPS MEDICAL, PC

Provider Business Mailing Address
First Line	:	8 CLINTON PL
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10453-1707
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8 CLINTON PL
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10453-1707
Country	:	US
Telephone Number	:	516-721-4665
Fax Number	:

Authorized Official
Title or Position	:	FAMILY PRACTITIONER
Name	:	ELENA PLAVNIK
Credential	:	D.O.
Telephone Number	:	516-721-4665

Provider Enumeration Date	:	09/18/2013
Last Update Date	:	09/18/2013

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