| Mag Medical, Pc | |
|
2379 65th St Brooklyn NY 11204-4045 | |
| (718) 375-0392 | |
| (718) 375-4324 |
| Full Name | Mag Medical, Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2379 65th St, Brooklyn, New York |
| Authorized Official Name and Position | Alexander Merson (OWNER) |
| Authorized Official Contact | 7183750392 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mag Medical, Pc 27 Beaumont St Brooklyn NY 11235-4103 Ph: (718) 375-0392 | Mag Medical, Pc 2379 65th St Brooklyn NY 11204-4045 Ph: (718) 375-0392 |
| NPI Number | 1215008040 |
|---|---|
| Provider Enumeration Date | 11/13/2006 |
| Last Update Date | 11/03/2009 |
| Medicare PECOS PAC ID | 0941191456 |
|---|---|
| Medicare Enrollment ID | O20040323001736 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215008040 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 196595 (New York) | Primary |
| Provider Name | Alexander Merson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1194755983 PECOS PAC ID: 9032100722 Enrollment ID: I20040520001511 |
| Provider Name | Lyudmila Poretskaya |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1558386409 PECOS PAC ID: 7315938008 Enrollment ID: I20040520001582 |
| Provider Name | Stuart Okin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770563538 PECOS PAC ID: 7012966609 Enrollment ID: I20050124000401 |
| Provider Name | Malvina Sher |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1629102074 PECOS PAC ID: 4284819889 Enrollment ID: I20110426000087 |
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