| Prospect Lefferts Gardens Medical Pc | |
|
309 Winthrop St Brooklyn NY 11225-3813 | |
| (718) 593-7770 | |
| Not Available |
| Full Name | Prospect Lefferts Gardens Medical Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 309 Winthrop St, Brooklyn, New York |
| Authorized Official Name and Position | Audanis Vertus (MEDICAL DIRECTOR/ OWNER) |
| Authorized Official Contact | 7189537770 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Prospect Lefferts Gardens Medical Pc 309 Winthrop St Brooklyn NY 11225-3813 Ph: (718) 953-7770 | Prospect Lefferts Gardens Medical Pc 309 Winthrop St Brooklyn NY 11225-3813 Ph: (718) 593-7770 |
| NPI Number | 1881914240 |
|---|---|
| Provider Enumeration Date | 06/09/2010 |
| Last Update Date | 06/09/2010 |
| Medicare PECOS PAC ID | 0840321493 |
|---|---|
| Medicare Enrollment ID | O20100626000284 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881914240 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 198949 (New York) | Primary |
| Provider Name | Audanis Vertus |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376509737 PECOS PAC ID: 6002805942 Enrollment ID: I20040507000085 |
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