| 1501 Medical Pc | |
|
1501 80th St Ste 1 Brooklyn NY 11228-2533 | |
| (718) 837-2660 | |
| Not Available |
| Full Name | 1501 Medical Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 1501 80th St Ste 1, Brooklyn, New York |
| Authorized Official Name and Position | Ilya Pavlov Akselrud (OWNER) |
| Authorized Official Contact | 7188372660 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| 1501 Medical Pc 1501 80th St Ste 1 Brooklyn NY 11228-2533 Ph: (718) 837-2660 | 1501 Medical Pc 1501 80th St Ste 1 Brooklyn NY 11228-2533 Ph: (718) 837-2660 |
| NPI Number | 1083921779 |
|---|---|
| Provider Enumeration Date | 09/02/2010 |
| Last Update Date | 09/02/2010 |
| Medicare PECOS PAC ID | 6002072923 |
|---|---|
| Medicare Enrollment ID | O20120723000142 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083921779 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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