| Healthway Medical P.c. | |
|
2195 E 22nd St Suite 1c Brooklyn NY 11229-3602 | |
| (718) 648-4545 | |
| (718) 648-7788 |
| Full Name | Healthway Medical P.c. |
|---|---|
| Speciality | Internal Medicine |
| Location | 2195 E 22nd St, Brooklyn, New York |
| Authorized Official Name and Position | Irina Lelchuk (OWNER) |
| Authorized Official Contact | 7186484545 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Healthway Medical P.c. 2195 E 22nd St Suite 1c Brooklyn NY 11229-3602 Ph: (718) 648-4545 | Healthway Medical P.c. 2195 E 22nd St Suite 1c Brooklyn NY 11229-3602 Ph: (718) 648-4545 |
| NPI Number | 1720058563 |
|---|---|
| Provider Enumeration Date | 01/24/2006 |
| Last Update Date | 10/22/2007 |
| Medicare PECOS PAC ID | 4385631688 |
|---|---|
| Medicare Enrollment ID | O20040428001154 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720058563 | NPI | - | NPPES |
| 02141688 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | A216744-1 (New York) | Primary |
| Provider Name | Irina Lelchuk |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942202437 PECOS PAC ID: 7517953615 Enrollment ID: I20040423000401 |
| Provider Name | Tatyana Taver |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508829474 PECOS PAC ID: 3577500073 Enrollment ID: I20050415000609 |
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