| Igny Medical Pc | |
|
3048 Brighton 1st St # 6b Brooklyn NY 11235-8080 | |
| (718) 945-4545 | |
| (347) 702-9545 |
| Full Name | Igny Medical Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 3048 Brighton 1st St # 6b, Brooklyn, New York |
| Authorized Official Name and Position | Igor Zhuravenko (PRESIDENT) |
| Authorized Official Contact | 3474897777 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Igny Medical Pc 197 Beach 137th St Rockaway Park NY 11694 Ph: (347) 489-7777 | Igny Medical Pc 3048 Brighton 1st St # 6b Brooklyn NY 11235-8080 Ph: (718) 945-4545 |
| NPI Number | 1437661741 |
|---|---|
| Provider Enumeration Date | 10/26/2017 |
| Last Update Date | 11/07/2020 |
| Medicare PECOS PAC ID | 0042631830 |
|---|---|
| Medicare Enrollment ID | O20200603001518 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437661741 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 210937 (New York) | Primary |
| Provider Name | Igor N Zhuravenko |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962438598 PECOS PAC ID: 5294649828 Enrollment ID: I20040319000966 |
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