Sonoma Medical P.c. | |
21 Washington Ave Brentwood NY 11717-3215 | |
(347) 624-3341 | |
(347) 789-7415 |
Full Name | Sonoma Medical P.c. |
---|---|
Speciality | Psychiatry & Neurology - Neurology |
Location | 21 Washington Ave, Brentwood, New York |
Authorized Official Name and Position | Arkady Yusupov (PRESIDENT) |
Authorized Official Contact | 3476243341 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Sonoma Medical P.c. 1361 Broadway Apt B32 Hewlett NY 11557-1342 Ph: (347) 624-3341 | Sonoma Medical P.c. 21 Washington Ave Brentwood NY 11717-3215 Ph: (347) 624-3341 |
NPI Number | 1770198871 |
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Provider Enumeration Date | 09/15/2020 |
Last Update Date | 09/15/2020 |
Certification Date | 09/15/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1770198871 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
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