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NPI Code Detail

MEDICARE: COMMUNITY MEDICAL OF CONEY ISLAND, PC

MEDICARE: COMMUNITY MEDICAL OF CONEY ISLAND, 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
1261Q00000XClinic/Center184579NY

General Provider Information

NPI Number : 1891976692
Entity Type Code : Organization
Provider Name (Legal Business Name) : COMMUNITY MEDICAL OF CONEY ISLAND, PC
Provider Business Mailing Address
First Line : 1048 CONEY ISLAND AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11230-2303
Country : US
Telephone Number : 718-421-2300
Fax Number : 718-421-2305
Provider Business Practice Location Address
First Line : 1048 CONEY ISLAND AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11230-2303
Country : US
Telephone Number : 718-421-2300
Fax Number : 718-421-2305
Authorized Official
Title or Position : OWNER
Name : DR. IMADUDDIN SYED HASHMI
Credential : MD
Telephone Number : 718-421-2300
Provider Enumeration Date : 11/20/2007
Last Update Date : 11/20/2007

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Directions to “COMMUNITY MEDICAL OF CONEY ISLAND, PC ” Practice Location

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