MEDICARE: NATALIE 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	219427	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	:	1710161971
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NATALIE MEDICAL PC

Provider Business Mailing Address
First Line	:	885 PATTERSON AVE
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10306-6029
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2124 KNAPP ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11229-5609
Country	:	US
Telephone Number	:	718-332-7777
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	NATALIE ARNOFF
Credential	:	D.O.
Telephone Number	:	718-332-7777

Provider Enumeration Date	:	12/24/2007
Last Update Date	:	01/11/2008

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