58TH STREET MEDICAL, PLLC

NPI 1548552276 Active Internal Medicine

Quick Facts

NPI Number

1548552276

Type

Organization (NPI-2)

Status

Active

Enumeration Date

2011-05-13

Last Updated (NPPES)

2011-11-09

Primary Specialty / Taxonomy

Taxonomy	Internal Medicine
Taxonomy Code	`207R00000X`
License	162832 NY

Other Taxonomies

Pediatrics

Practice Address

1153 58TH ST
BROOKLYN, NY 112194526

Phone: 718-431-9870

Mailing Address

1153 58TH ST
BROOKLYN, NY 112194526

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