| Family Medical Care Of Marine Park, P.c. | |
|
2915 Avenue S Brooklyn NY 11229-2544 | |
| (718) 998-9669 | |
| (718) 339-5614 |
| Full Name | Family Medical Care Of Marine Park, P.c. |
|---|---|
| Speciality | Family Medicine |
| Location | 2915 Avenue S, Brooklyn, New York |
| Authorized Official Name and Position | Eugene John Mancuso (PRESIDENT) |
| Authorized Official Contact | 7189989669 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Medical Care Of Marine Park, P.c. 2915 Avenue S Brooklyn NY 11229 Ph: (718) 998-9669 | Family Medical Care Of Marine Park, P.c. 2915 Avenue S Brooklyn NY 11229-2544 Ph: (718) 998-9669 |
| NPI Number | 1902004484 |
|---|---|
| Provider Enumeration Date | 07/06/2007 |
| Last Update Date | 05/28/2014 |
| Medicare PECOS PAC ID | 4284675877 |
|---|---|
| Medicare Enrollment ID | O20050513000133 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902004484 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Maria Pellegrino |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1376583740 PECOS PAC ID: 2264409044 Enrollment ID: I20040911000300 |
| Provider Name | Eugene J Mancuso |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831234442 PECOS PAC ID: 2264473867 Enrollment ID: I20050528000021 |
| Provider Name | Ian Michael Wall |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1528170792 PECOS PAC ID: 2163420639 Enrollment ID: I20061116000203 |
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