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NPI Code Detail

MEDICARE: PRISTINE MEDICAL CARE PLLC

MEDICARE: PRISTINE 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 Physician
2208000000XPediatrics Physician

General Provider Information

NPI Number : 1598796245
Entity Type Code : Organization
Provider Name (Legal Business Name) : PRISTINE MEDICAL CARE PLLC
Provider Business Mailing Address
First Line : 7209 16TH AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11204-5106
Country : US
Telephone Number : 718-975-0068
Fax Number : 718-975-0104
Provider Business Practice Location Address
First Line : 7209 16TH AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11204-5106
Country : US
Telephone Number : 718-975-0068
Fax Number : 718-975-0104
Authorized Official
Title or Position : DIRECTOR
Name : MIN A WONG
Credential : MD
Telephone Number : 718-975-0068
Provider Enumeration Date : 07/05/2006
Last Update Date : 09/11/2025

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Directions to “PRISTINE MEDICAL CARE PLLC ” Practice Location

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