MEDICARE: AESCULAPIUS 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	207R00000X	Internal Medicine Physician	216120	NY

General Provider Information

NPI Number	:	1730194325
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AESCULAPIUS MEDICAL PC

Provider Business Mailing Address
First Line	:	3062 BRIGHTON 3RD ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11235-7409
Country	:	US
Telephone Number	:	718-769-0090
Fax Number	:	718-743-9680

Provider Business Practice Location Address
First Line	:	3062 BRIGHTON 3RD ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11235-7409
Country	:	US
Telephone Number	:	718-769-0090
Fax Number	:	718-743-9680

Authorized Official
Title or Position	:	OWNER
Name	:	DR. SIMON URMAN
Credential	:	M.D.
Telephone Number	:	718-769-0090

Provider Enumeration Date	:	07/30/2006
Last Update Date	:	05/07/2008

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