MEDICARE: AMERICAN 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
1	207R00000X	Internal Medicine Physician	180953	NY

General Provider Information

NPI Number	:	1992937627
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMERICAN MEDICAL SERVICES, PC

Provider Business Mailing Address
First Line	:	942 ROCKAWAY AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11212-5237
Country	:	US
Telephone Number	:	718-613-1500
Fax Number	:	347-342-6163

Provider Business Practice Location Address
First Line	:	490 NEW YORK AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11225-4264
Country	:	US
Telephone Number	:	718-613-1500
Fax Number	:	347-342-6163

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DEXTER MCKENZIE
Credential	:	M.D.
Telephone Number	:	718-613-1500

Provider Enumeration Date	:	08/13/2009
Last Update Date	:	08/12/2014

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