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NPI Code Detail

MEDICARE: TOTAL MEDICAL PC

MEDICARE: TOTAL 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
1207Q00000XFamily Medicine Physician180598NY

General Provider Information

NPI Number : 1811006083
Entity Type Code : Organization
Provider Name (Legal Business Name) : TOTAL MEDICAL PC
Provider Business Mailing Address
First Line : 3039 OCEAN PKWY
Second Line :
City : BROOKLYN
State : NY
Zip : 11235-8370
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4405 BROADWAY
Second Line :
City : NEW YORK
State : NY
Zip : 10040-4014
Country : US
Telephone Number : 212-740-2020
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : MIHAIL MEDVEDOVSKY
Credential : MD
Telephone Number : 212-740-2020
Provider Enumeration Date : 08/30/2006
Last Update Date : 05/07/2008

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Directions to “TOTAL MEDICAL PC ” Practice Location

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