MEDICARE: NEW YORK COMMUNITY MEDICAL CARE, 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	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1588977086
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEW YORK COMMUNITY MEDICAL CARE, PC

Provider Business Mailing Address
First Line	:	1236 FULTON ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11216-2093
Country	:	US
Telephone Number	:	718-622-7300
Fax Number	:

Provider Business Practice Location Address
First Line	:	1236 FULTON ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11216-2093
Country	:	US
Telephone Number	:	718-622-7300
Fax Number	:

Authorized Official
Title or Position	:	CHAIRMAN
Name	:	TAHMINA SIKDER
Credential	:	MD
Telephone Number	:	347-813-1658

Provider Enumeration Date	:	07/26/2010
Last Update Date	:	07/27/2010

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