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NPI Code Detail

MEDICARE: DR. EVELYN R GHATAN MD

MEDICARE: DR. EVELYN R GHATAN MD
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
1208000000XPediatrics Physician197437NY

General Provider Information

NPI Number : 1811951494
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. EVELYN R GHATAN MD
Provider Business Mailing Address
First Line : 1226 OCEAN PKWY
Second Line :
City : BROOKLYN
State : NY
Zip : 11230-5102
Country : US
Telephone Number : 718-253-2053
Fax Number : 718-253-2051
Provider Business Practice Location Address
First Line : 1226 OCEAN PKWY
Second Line :
City : BROOKLYN
State : NY
Zip : 11230-5102
Country : US
Telephone Number : 718-253-2053
Fax Number : 718-253-2051
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/12/2006
Last Update Date : 02/20/2009

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