| Omer Tipu Physician Pc | |
|
446 Mcdonald Ave Brooklyn NY 11218-2212 | |
| (718) 972-4200 | |
| Not Available |
| Full Name | Omer Tipu Physician Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 446 Mcdonald Ave, Brooklyn, New York |
| Authorized Official Name and Position | Omer Tipu (PRESIDENT) |
| Authorized Official Contact | 7189724200 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Omer Tipu Physician Pc 710 Sunnyview Oval Keasbey NJ 08832-1039 Ph: (718) 972-4200 | Omer Tipu Physician Pc 446 Mcdonald Ave Brooklyn NY 11218-2212 Ph: (718) 972-4200 |
| NPI Number | 1780004358 |
|---|---|
| Provider Enumeration Date | 04/23/2014 |
| Last Update Date | 08/01/2014 |
| Medicare PECOS PAC ID | 8022234129 |
|---|---|
| Medicare Enrollment ID | O20140725001583 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780004358 | NPI | - | NPPES |
| 03850084 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QG0300X | Family Medicine - Geriatric Medicine | (* (Not Available)) | Primary |
| Provider Name | Omer K Tipu |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669601159 PECOS PAC ID: 7012180326 Enrollment ID: I20111102000389 |
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