| American Wound Care Medicine Pllc | |
|
3514 Mermaid Ave Brooklyn NY 11224-1508 | |
| (410) 972-7056 | |
| Not Available |
| Full Name | American Wound Care Medicine Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 3514 Mermaid Ave, Brooklyn, New York |
| Authorized Official Name and Position | Saba Azizi-ghannad (OWNER) |
| Authorized Official Contact | 2519013011 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| American Wound Care Medicine Pllc 11340 Lakefield Dr Ste 200 Johns Creek GA 30097-2456 Ph: () - | American Wound Care Medicine Pllc 3514 Mermaid Ave Brooklyn NY 11224-1508 Ph: (410) 972-7056 |
| NPI Number | 1942074653 |
|---|---|
| Provider Enumeration Date | 11/13/2023 |
| Last Update Date | 05/17/2024 |
| Medicare PECOS PAC ID | 6709237118 |
|---|---|
| Medicare Enrollment ID | O20240110003303 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942074653 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QA0505X | Family Medicine - Adult Medicine | (* (Not Available)) | Primary |
| Provider Name | Jennifer Polatchek |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245793900 PECOS PAC ID: 6002243672 Enrollment ID: I20211202001328 |
| Provider Name | Judy I Thomas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689317711 PECOS PAC ID: 5496122533 Enrollment ID: I20221102003516 |
| Provider Name | Saba Azizi-ghannad |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295255842 PECOS PAC ID: 3072920651 Enrollment ID: I20240110003559 |
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