| Litvinova Medical Pc | |
|
110 4th Ave Brooklyn NY 11217-2787 | |
| (646) 202-2968 | |
| (718) 857-8415 |
| Full Name | Litvinova Medical Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 110 4th Ave, Brooklyn, New York |
| Authorized Official Name and Position | Larisa Litvinova (PRESIDENT) |
| Authorized Official Contact | 6462022968 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Litvinova Medical Pc 110 4th Ave Brooklyn NY 11217-2787 Ph: (646) 202-2968 | Litvinova Medical Pc 110 4th Ave Brooklyn NY 11217-2787 Ph: (646) 202-2968 |
| NPI Number | 1043455686 |
|---|---|
| Provider Enumeration Date | 12/11/2008 |
| Last Update Date | 09/25/2023 |
| Medicare PECOS PAC ID | 9638231301 |
|---|---|
| Medicare Enrollment ID | O20081215000700 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043455686 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 219127 (New York) | Primary |
| Provider Name | Larisa Litvinova |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1558443739 PECOS PAC ID: 4486715406 Enrollment ID: I20081210000072 |
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