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NPI Code Detail

MEDICARE: 8TH AVE PHYSICAL MEDICINE P.C.

MEDICARE: 8TH AVE PHYSICAL MEDICINE P.C.
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
1208100000XPhysical Medicine & Rehabilitation Physician228967NY

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1WWS871OTHERMEDICARE

General Provider Information

NPI Number : 1750421335
Entity Type Code : Organization
Provider Name (Legal Business Name) : 8TH AVE PHYSICAL MEDICINE P.C.
Provider Business Mailing Address
First Line : 743 58TH ST LOWR LEVEL
Second Line :
City : BROOKLYN
State : NY
Zip : 11220-3916
Country : US
Telephone Number : 718-765-1788
Fax Number : 718-765-1789
Provider Business Practice Location Address
First Line : 743 58TH ST LOWR LEVEL
Second Line :
City : BROOKLYN
State : NY
Zip : 11220-3916
Country : US
Telephone Number : 718-765-1788
Fax Number : 718-765-1789
Authorized Official
Title or Position : PRESIDENT
Name : DR. JOYCE HO
Credential : M.D.
Telephone Number : 718-765-1788
Provider Enumeration Date : 02/06/2007
Last Update Date : 03/04/2008

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