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NPI Code Detail

MEDICARE: BRIGHTON MEDICAL DIAGNOSTIC

MEDICARE: BRIGHTON MEDICAL DIAGNOSTIC
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 Physician
2225100000XPhysical Therapist
3261QR0200XRadiology Clinic/Center

General Provider Information

NPI Number : 1891925095
Entity Type Code : Organization
Provider Name (Legal Business Name) : BRIGHTON MEDICAL DIAGNOSTIC
Provider Business Mailing Address
First Line : 1150 BRIGHTON BEACH AVE
Second Line : #1CC
City : BROOKLYN
State : NY
Zip : 11235-5901
Country : US
Telephone Number : 917-476-8977
Fax Number :
Provider Business Practice Location Address
First Line : 1150 BRIGHTON BEACH AVE
Second Line : #1CC
City : BROOKLYN
State : NY
Zip : 11235-5901
Country : US
Telephone Number : 917-476-8977
Fax Number :
Authorized Official
Title or Position : OWNER
Name : HAMID ALAM
Credential : M.D.
Telephone Number : 917-476-8977
Provider Enumeration Date : 07/22/2009
Last Update Date : 07/22/2009

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Directions to “BRIGHTON MEDICAL DIAGNOSTIC ” Practice Location

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