| Simon Fensterszaub Do Pc | |
|
407 Willoughby Ave Brooklyn NY 11205-4590 | |
| (187) 470-0288 | |
| Not Available |
| Full Name | Simon Fensterszaub Do Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 407 Willoughby Ave, Brooklyn, New York |
| Authorized Official Name and Position | Yitty Falkowitz (DO) |
| Authorized Official Contact | 2127346621 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Simon Fensterszaub Do Pc 250 Skillman St Ste 202 Brooklyn NY 11205-1218 Ph: (212) 734-6621 | Simon Fensterszaub Do Pc 407 Willoughby Ave Brooklyn NY 11205-4590 Ph: (187) 470-0288 |
| NPI Number | 1124460696 |
|---|---|
| Provider Enumeration Date | 07/24/2013 |
| Last Update Date | 02/15/2023 |
| Medicare PECOS PAC ID | 9133403074 |
|---|---|
| Medicare Enrollment ID | O20170221002238 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124460696 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 249846 (New York) | Primary |
| Provider Name | Simon Fensterszaub |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003077322 PECOS PAC ID: 5890970230 Enrollment ID: I20110428000025 |
| Provider Name | Lauren Guse |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770990210 PECOS PAC ID: 8325366990 Enrollment ID: I20150410000161 |
| Provider Name | Ashley Thomas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578087300 PECOS PAC ID: 9133487747 Enrollment ID: I20190108000768 |
| Provider Name | Leilani Tandoc |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538621537 PECOS PAC ID: 7517290471 Enrollment ID: I20190607000392 |
| Provider Name | Imee Dhir |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316304645 PECOS PAC ID: 2860799327 Enrollment ID: I20230608002847 |
| Provider Name | Aharon Feldman |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1235584962 PECOS PAC ID: 8921379249 Enrollment ID: I20240605001805 |
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