| Alla Shustarovich Md Pc | |
|
99 Brighton 11 Street Brooklyn NY 11235 | |
| (718) 332-7411 | |
| (718) 332-7412 |
| Full Name | Alla Shustarovich Md Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 99 Brighton 11 Street, Brooklyn, New York |
| Authorized Official Name and Position | Alla Shustarovich (MD) |
| Authorized Official Contact | 7183327411 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Alla Shustarovich Md Pc 99 Brighton 11 Street Brooklyn NY 11235 Ph: (718) 332-7411 | Alla Shustarovich Md Pc 99 Brighton 11 Street Brooklyn NY 11235 Ph: (718) 332-7411 |
| NPI Number | 1245509454 |
|---|---|
| Provider Enumeration Date | 12/16/2011 |
| Last Update Date | 12/16/2011 |
| Medicare PECOS PAC ID | 8820264252 |
|---|---|
| Medicare Enrollment ID | O20120105000692 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245509454 | NPI | - | NPPES |
| 01665952 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 203553 (New York) | Primary |
| Provider Name | Alla Shustarovich |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1356315527 PECOS PAC ID: 8628244068 Enrollment ID: I20120105000735 |
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