MEDICARE: TRIUNE OB/GYN SERVICES, LLC

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	174400000X	Specialist	195127	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1700896875
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRIUNE OB/GYN SERVICES, LLC

Provider Business Mailing Address
First Line	:	975 JEROME ST
Second Line	:
City	:	BALDWIN
State	:	NY
Zip	:	11510-5018
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1416 BEVERLEY RD
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11226-4514
Country	:	US
Telephone Number	:	718-469-3377
Fax Number	:

Authorized Official
Title or Position	:	SOLE PROPRIETER
Name	:	JACQUELINE FORD
Credential	:
Telephone Number	:	718-469-3377

Provider Enumeration Date	:	08/09/2006
Last Update Date	:	08/22/2020

Similar Medicare Providers

1477654523 — SOTA MEDICAL SERVICES PC
Practice Location Address:

1416 BEVERLEY RD
BROOKLYN, NY
11226-4514

Practice Phone: 718-469-3377
Practice Fax:

1124199922 — DR. RUTHVEN NOEL MD
Practice Location Address:

1416 BEVERLEY RD
BROOKLYN, NY
11226-4514

Practice Phone: 718-469-3377
Practice Fax: 718-469-3865

1174664940 — SOTA MEDICAL SERVICES PC
Practice Location Address:

1416 BEVERLEY RD
BROOKLYN, NY
11226-4514

Practice Phone: 718-469-0033
Practice Fax:

1194075069 — JENNIFER BECKER MSTOM L.AC
Practice Location Address:

1422 BEVERLEY RD
BROOKLYN, NY
11226-4514

Practice Phone: 815-375-0370
Practice Fax:

1639800220 — FRAIDA ZELINGER
Practice Location Address:

4514 16TH AVE
BROOKLYN, NY
11204-1101

Practice Phone: 718-407-7300
Practice Fax:

1447204185 — SARA LEAH TARSIS M.D.
Practice Location Address:

4514 16TH AVE FL 4THE
BROOKLYN, NY
11204-1101

Practice Phone: 718-407-7300
Practice Fax: 718-400-9012

Directions to “TRIUNE OB/GYN SERVICES, LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.