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NPI Code Detail

MEDICARE: PROMINIS MEDICAL SERVICES PC

MEDICARE: PROMINIS MEDICAL SERVICES 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
1207R00000XInternal Medicine Physician232171NY

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2DD0279OTHERNYRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1841323771
Entity Type Code : Organization
Provider Name (Legal Business Name) : PROMINIS MEDICAL SERVICES PC
Provider Business Mailing Address
First Line : 381 5TH ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11215-2806
Country : US
Telephone Number : 718-852-5252
Fax Number : 718-802-1113
Provider Business Practice Location Address
First Line : 332 DEKALB AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11205-3820
Country : US
Telephone Number : 718-852-5252
Fax Number : 718-802-1113
Authorized Official
Title or Position : OWNER
Name : ANDRAS FENYVES
Credential : MD
Telephone Number : 718-852-5252
Provider Enumeration Date : 03/13/2007
Last Update Date : 12/03/2025

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Directions to “PROMINIS MEDICAL SERVICES PC ” Practice Location

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