| Bitachon 412 LLC | |
|
1648 E 14th St Ste 1 Brooklyn NY 11229-1175 | |
| (718) 998-2350 | |
| Not Available |
| Full Name | Bitachon 412 LLC |
|---|---|
| Speciality | Internal Medicine |
| Location | 1648 E 14th St Ste 1, Brooklyn, New York |
| Authorized Official Name and Position | Sharon Kheradnam (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 3478704732 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bitachon 412 LLC 1648 E 14th St Ste 1 Brooklyn NY 11229-1175 | Bitachon 412 LLC 1648 E 14th St Ste 1 Brooklyn NY 11229-1175 Ph: (718) 998-2350 |
| NPI Number | 1528956992 |
|---|---|
| Provider Enumeration Date | 06/25/2025 |
| Last Update Date | 06/25/2025 |
| Certification Date | 06/25/2025 |
| Medicare PECOS PAC ID | 0345753133 |
|---|---|
| Medicare Enrollment ID | O20250703001795 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528956992 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | () | Primary |
| Provider Name | Sharon Kheradnam |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1063823664 PECOS PAC ID: 2567715378 Enrollment ID: I20210629003539 |
| Provider Name | Leora Nakhon |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1477224939 PECOS PAC ID: 8921491952 Enrollment ID: I20220215001218 |
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