| Greene Avenue Medical, Pc | |
|
1350 Greene Ave Fl 2 Brooklyn NY 11237-4902 | |
| (718) 628-8216 | |
| (718) 628-4755 |
| Full Name | Greene Avenue Medical, Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1350 Greene Ave Fl 2, Brooklyn, New York |
| Authorized Official Name and Position | Elide Sterlin (PRESIDENT/TRUSTEE) |
| Authorized Official Contact | 5709727511 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Greene Avenue Medical, Pc 1350 Greene Ave Fl 2 Brooklyn NY 11237-4902 Ph: (718) 628-8216 | Greene Avenue Medical, Pc 1350 Greene Ave Fl 2 Brooklyn NY 11237-4902 Ph: (718) 628-8216 |
| NPI Number | 1811431323 |
|---|---|
| Provider Enumeration Date | 12/19/2016 |
| Last Update Date | 12/19/2016 |
| Medicare PECOS PAC ID | 7810279122 |
|---|---|
| Medicare Enrollment ID | O20170123000380 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811431323 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 157407 (New York) | Primary |
| Provider Name | Joseph Thomas |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023082039 PECOS PAC ID: 9931126703 Enrollment ID: I20051031000940 |
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