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NPI Code Detail

MEDICARE: BROOKLYN COMMUNITY MEDCAIL PC

MEDICARE: BROOKLYN COMMUNITY MEDCAIL 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
1174400000XSpecialist025228NY

General Provider Information

NPI Number : 1902872229
Entity Type Code : Organization
Provider Name (Legal Business Name) : BROOKLYN COMMUNITY MEDCAIL PC
Provider Business Mailing Address
First Line : 2555 NOSTRAND AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11210-4730
Country : US
Telephone Number : 718-951-8800
Fax Number : 718-951-0846
Provider Business Practice Location Address
First Line : 2555 NOSTRAND AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11210-4730
Country : US
Telephone Number : 718-951-8800
Fax Number : 718-951-0846
Authorized Official
Title or Position : PT
Name : DR. ROCHEL FISHMAN
Credential : PT
Telephone Number : 718-951-8800
Provider Enumeration Date : 02/27/2006
Last Update Date : 08/22/2020

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Directions to “BROOKLYN COMMUNITY MEDCAIL PC ” Practice Location

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