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NPI Verification

National Provider Identifier: 1134256761

21st Avenue Medical Plaza PC

Organization

Primary Specialty

Family Medicine

Code: 207Q00000X

All Specialties (3)

Physical Medicine & Rehabilitation

Code: 208100000X

Code: 208VP0000X

Family Medicine

Code: 207Q00000X

Primary

Practice Address

2101 E 16TH ST

BROOKLYN, NY 112294401

Phone: 718-266-9779

NPI Enumeration Date

February 28, 2007

NPI Number

1134256761

Data sourced from the official CMS NPPES Registry. This information is provided by the Centers for Medicare & Medicaid Services and is updated regularly.

View on CMS NPPES Registry