| Beautiful Mind Medical, Pc | |
|
2218 Kimball St Suite M5 Brooklyn NY 11234-5103 | |
| (718) 253-1087 | |
| (718) 253-7774 |
| Full Name | Beautiful Mind Medical, Pc |
|---|---|
| Speciality | Psychologist |
| Location | 2218 Kimball St, Brooklyn, New York |
| Authorized Official Name and Position | Valeriy Chernov (PHISICIAN) |
| Authorized Official Contact | 7182531087 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Beautiful Mind Medical, Pc 2218 Kimball St Suite M5 Brooklyn NY 11234-5103 Ph: (718) 253-1087 | Beautiful Mind Medical, Pc 2218 Kimball St Suite M5 Brooklyn NY 11234-5103 Ph: (718) 253-1087 |
| NPI Number | 1790952570 |
|---|---|
| Provider Enumeration Date | 05/12/2008 |
| Last Update Date | 05/12/2008 |
| Medicare PECOS PAC ID | 7911965280 |
|---|---|
| Medicare Enrollment ID | O20050103000914 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790952570 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TP0016X | Psychologist - Prescribing (medical) | 232633 (New York) | Primary |
| Provider Name | Valeriy M Chernov |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1144232257 PECOS PAC ID: 0749245561 Enrollment ID: I20041122000321 |
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