| New York Medical Clinic | |
|
2503 Church Ave Brooklyn NY 11226-4060 | |
| (718) 427-6160 | |
| Not Available |
| Full Name | New York Medical Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 2503 Church Ave, Brooklyn, New York |
| Authorized Official Name and Position | Jerry Uduevbo (MEDICAL DIRECTOR) |
| Authorized Official Contact | 7184276160 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| New York Medical Clinic 2503 Church Ave Brooklyn NY 11226-4060 Ph: () - | New York Medical Clinic 2503 Church Ave Brooklyn NY 11226-4060 Ph: (718) 427-6160 |
| NPI Number | 1033436365 |
|---|---|
| Provider Enumeration Date | 04/26/2010 |
| Last Update Date | 04/26/2010 |
| Medicare PECOS PAC ID | 6507981669 |
|---|---|
| Medicare Enrollment ID | O20100913000564 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033436365 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 249063 (New York) | Primary |
| Provider Name | Ian D Prescott |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1760461776 PECOS PAC ID: 5294746749 Enrollment ID: I20060511000314 |
| Provider Name | Jerry Uduevbo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1740448208 PECOS PAC ID: 7810059797 Enrollment ID: I20081231000377 |
| Provider Name | Fatima Olude |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740707975 PECOS PAC ID: 3870855406 Enrollment ID: I20180320001101 |
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