| Boro Park Medical P.c. | |
|
1379 54th St Brooklyn NY 11219-4259 | |
| (718) 436-1600 | |
| (718) 436-2085 |
| Full Name | Boro Park Medical P.c. |
|---|---|
| Speciality | Internal Medicine |
| Location | 1379 54th St, Brooklyn, New York |
| Authorized Official Name and Position | Josif Sholomon (OWNER) |
| Authorized Official Contact | 7184361600 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Boro Park Medical P.c. 1379 54th St Brooklyn NY 11219-4259 Ph: (718) 436-1600 | Boro Park Medical P.c. 1379 54th St Brooklyn NY 11219-4259 Ph: (718) 436-1600 |
| NPI Number | 1790815736 |
|---|---|
| Provider Enumeration Date | 03/07/2007 |
| Last Update Date | 02/24/2010 |
| Medicare PECOS PAC ID | 5395642714 |
|---|---|
| Medicare Enrollment ID | O20031215000605 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790815736 | NPI | - | NPPES |
| 7218155 | Other | NY | AETNA |
| 02559608 | Medicaid | NY | |
| 2596135 | Other | NY | GHI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 189657 (New York) | Primary |
| Provider Name | Daniel Eli Beyda |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1437136579 PECOS PAC ID: 5799698577 Enrollment ID: I20031107000356 |
| Provider Name | Dima Teitelman |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1548285497 PECOS PAC ID: 2264324714 Enrollment ID: I20040329000564 |
| Provider Name | Josif Sholomon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548261811 PECOS PAC ID: 3577460914 Enrollment ID: I20040518001299 |
| Provider Name | Lily Weinstein |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174510408 PECOS PAC ID: 6608867098 Enrollment ID: I20040524000659 |
| Provider Name | Victoria Beyda |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1922085067 PECOS PAC ID: 0749264216 Enrollment ID: I20040614001517 |
| Provider Name | Sidney Plawes |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1679510119 PECOS PAC ID: 6507816477 Enrollment ID: I20050128000429 |
| Provider Name | Vadim A Kolesnikov |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1871652974 PECOS PAC ID: 0244360535 Enrollment ID: I20100614000114 |
| Provider Name | Alanna Sholomon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1710148127 PECOS PAC ID: 5193994077 Enrollment ID: I20110810000282 |
| Provider Name | Nathaniel Margolis |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1073747259 PECOS PAC ID: 4183943889 Enrollment ID: I20150430001808 |
| Provider Name | Dianna Sholomon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1063830370 PECOS PAC ID: 1850658063 Enrollment ID: I20171127000759 |
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