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NPI Code Detail

MEDICARE: AVE P MEDICAL PC

MEDICARE: AVE P 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
1207L00000XAnesthesiology Physician

General Provider Information

NPI Number : 1689958001
Entity Type Code : Organization
Provider Name (Legal Business Name) : AVE P MEDICAL PC
Provider Business Mailing Address
First Line : 130 AVENUE P
Second Line :
City : BROOKLYN
State : NY
Zip : 11204-6362
Country : US
Telephone Number : 718-372-7434
Fax Number : 718-266-2663
Provider Business Practice Location Address
First Line : 130 AVENUE P
Second Line :
City : BROOKLYN
State : NY
Zip : 11204-6362
Country : US
Telephone Number : 718-372-7434
Fax Number : 718-266-2663
Authorized Official
Title or Position : OWNER
Name : DR. RAKESH GUPTA
Credential : M.D.
Telephone Number : 718-372-7434
Provider Enumeration Date : 10/04/2011
Last Update Date : 10/04/2011

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Directions to “AVE P MEDICAL PC ” Practice Location

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