| Nova Vita Medical Pc | |
|
887 Rutland Rd Brooklyn NY 11203 | |
| (347) 627-6385 | |
| (347) 413-9888 |
| Full Name | Nova Vita Medical Pc |
|---|---|
| Speciality | Allergy & Immunology |
| Location | 887 Rutland Rd, Brooklyn, New York |
| Authorized Official Name and Position | Ubong Jackson Udoyen (MD) |
| Authorized Official Contact | 8032697381 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Nova Vita Medical Pc 887 Rutland Rd Brooklyn NY 11203-1911 Ph: (347) 627-6385 | Nova Vita Medical Pc 887 Rutland Rd Brooklyn NY 11203 Ph: (347) 627-6385 |
| NPI Number | 1760907166 |
|---|---|
| Provider Enumeration Date | 08/07/2017 |
| Last Update Date | 05/22/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760907166 | NPI | - | NPPES |
| 265463 | Other | NY | STATE LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Secondary |
| 207K00000X | Allergy & Immunology | (* (Not Available)) | Primary |
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