| Special Medical Pc | |
|
699 B Stanley Avenue Brooklyn NY 11207 | |
| (917) 554-5735 | |
| (347) 689-8860 |
| Full Name | Special Medical Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 699 B Stanley Avenue, Brooklyn, New York |
| Authorized Official Name and Position | Ilya Kleyn (PRESIDENT) |
| Authorized Official Contact | 9175545735 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Special Medical Pc 1837 E 17th St Apt 5a Brooklyn NY 11229-2961 Ph: (917) 554-5735 | Special Medical Pc 699 B Stanley Avenue Brooklyn NY 11207 Ph: (917) 554-5735 |
| NPI Number | 1548700925 |
|---|---|
| Provider Enumeration Date | 03/03/2017 |
| Last Update Date | 03/06/2017 |
| Medicare PECOS PAC ID | 2466737747 |
|---|---|
| Medicare Enrollment ID | O20170329000935 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548700925 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QA0505X | Family Medicine - Adult Medicine | 215006 (New York) | Primary |
| Provider Name | Ilya Kleyn |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851327092 PECOS PAC ID: 5890777304 Enrollment ID: I20040607000834 |
| Provider Name | Sofya A Kleyn |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1972628865 PECOS PAC ID: 3678665312 Enrollment ID: I20070824000832 |
| Provider Name | Gary N Eisendorf |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1629021084 PECOS PAC ID: 3971515354 Enrollment ID: I20090107000029 |
| Provider Name | Aasma Hafeez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497980866 PECOS PAC ID: 8628436755 Enrollment ID: I20230622002014 |
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