| Adult And Geriatric Medical Care Pc | |
|
4802 10th Ave Fl 10 Brooklyn NY 11219-2916 | |
| (917) 609-5537 | |
| (718) 630-3761 |
| Full Name | Adult And Geriatric Medical Care Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 4802 10th Ave Fl 10, Brooklyn, New York |
| Authorized Official Name and Position | Diana Levina (PRESIDENT) |
| Authorized Official Contact | 9176095537 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Adult And Geriatric Medical Care Pc 157 Beaumont St Brooklyn NY 11235-4118 Ph: (917) 609-4748 | Adult And Geriatric Medical Care Pc 4802 10th Ave Fl 10 Brooklyn NY 11219-2916 Ph: (917) 609-5537 |
| NPI Number | 1366567414 |
|---|---|
| Provider Enumeration Date | 03/20/2007 |
| Last Update Date | 09/20/2022 |
| Medicare PECOS PAC ID | 3678621380 |
|---|---|
| Medicare Enrollment ID | O20090507000476 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366567414 | NPI | - | NPPES |
| 03416084 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0300X | Internal Medicine - Geriatric Medicine | (* (Not Available)) | Primary |
| 261Q00000X | Clinic/center | 234232 (New York) | Secondary |
| Provider Name | Diana Levina |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114017472 PECOS PAC ID: 0446273247 Enrollment ID: I20060106000801 |
| Provider Name | Sergey I Genkin |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1942268701 PECOS PAC ID: 6608944756 Enrollment ID: I20081003000005 |
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