| Kings Medical Family Practice Pc | |
|
681 Flatbush Ave Brooklyn NY 11225-5698 | |
| (718) 975-2270 | |
| (718) 975-2271 |
| Full Name | Kings Medical Family Practice Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 681 Flatbush Ave, Brooklyn, New York |
| Authorized Official Name and Position | Jude Ozuzu (OWNER) |
| Authorized Official Contact | 6462344673 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kings Medical Family Practice Pc 4809 Avenue N Ste 273 Brooklyn NY 11234-3711 Ph: (718) 975-2270 | Kings Medical Family Practice Pc 681 Flatbush Ave Brooklyn NY 11225-5698 Ph: (718) 975-2270 |
| NPI Number | 1316461387 |
|---|---|
| Provider Enumeration Date | 08/01/2017 |
| Last Update Date | 08/01/2017 |
| Medicare PECOS PAC ID | 4082989645 |
|---|---|
| Medicare Enrollment ID | O20171006001510 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316461387 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Don B Bandari |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1558362673 PECOS PAC ID: 5597653253 Enrollment ID: I20040305000467 |
| Provider Name | John T Rigney |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1255449229 PECOS PAC ID: 6103814272 Enrollment ID: I20040505001559 |
| Provider Name | Jude Ozuzu |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568483733 PECOS PAC ID: 3971571175 Enrollment ID: I20040923001185 |
| Provider Name | Lesline Edwards |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235147711 PECOS PAC ID: 3072534338 Enrollment ID: I20051214000426 |
| Provider Name | Douglas N Weiner |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1679535017 PECOS PAC ID: 4486667979 Enrollment ID: I20060731000200 |
| Provider Name | Titus B Okunlola |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1699853515 PECOS PAC ID: 0840292975 Enrollment ID: I20070202000220 |
| Provider Name | Kesha V G Crichlow |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154746782 PECOS PAC ID: 6305064114 Enrollment ID: I20140820000319 |
| Provider Name | Al Adams |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1134528979 PECOS PAC ID: 6507189800 Enrollment ID: I20141217001479 |
| Provider Name | Lenore Shamah |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1033475157 PECOS PAC ID: 0547574816 Enrollment ID: I20150730011598 |
| Provider Name | Erica A Koleosho |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801253240 PECOS PAC ID: 3375828437 Enrollment ID: I20170403000553 |
| Provider Name | Philomene Goueliani |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891102885 PECOS PAC ID: 4385989243 Enrollment ID: I20181220002033 |
| Provider Name | Shamara Alterno |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902258338 PECOS PAC ID: 2264780667 Enrollment ID: I20190318001460 |
| Provider Name | Latoya Elizabeth Betton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003170275 PECOS PAC ID: 6507196631 Enrollment ID: I20191002002644 |
| Provider Name | Roman Fayzibayev |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467183749 PECOS PAC ID: 5496126294 Enrollment ID: I20230113000302 |
| Provider Name | Ashley Simon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881316438 PECOS PAC ID: 4082072582 Enrollment ID: I20230615000177 |
| Provider Name | Danita Ellison |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912521857 PECOS PAC ID: 2163881152 Enrollment ID: I20230710000725 |
| Provider Name | Eula Nelson Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619352804 PECOS PAC ID: 5496191132 Enrollment ID: I20240315002634 |
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