| It Medical Essence PC | |
|
2995 Ocean Pkwy Brooklyn NY 11235-8387 | |
| (718) 934-2211 | |
| (718) 934-2225 |
| Full Name | It Medical Essence PC |
|---|---|
| Speciality | Clinic/Center |
| Location | 2995 Ocean Pkwy, Brooklyn, New York |
| Authorized Official Name and Position | Igor a Talis (PRESIDENT) |
| Authorized Official Contact | 7189342211 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| It Medical Essence PC 2728 Kings Hwy Apt. F11 Brooklyn NY 11229-1768 Ph: (718) 934-2211 | It Medical Essence PC 2995 Ocean Pkwy Brooklyn NY 11235-8387 Ph: (718) 934-2211 |
| NPI Number | 1154649887 |
|---|---|
| Provider Enumeration Date | 05/05/2010 |
| Last Update Date | 05/05/2010 |
| Medicare PECOS PAC ID | 7315071651 |
|---|---|
| Medicare Enrollment ID | O20100823000335 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154649887 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 253007 (New York) | Primary |
| Provider Name | Nick Nicoloff |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1992769632 PECOS PAC ID: 2668428913 Enrollment ID: I20050329001396 |
| Provider Name | Igor Talis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457561920 PECOS PAC ID: 3678607926 Enrollment ID: I20100823000382 |
| Provider Name | Lada Galilova |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093925109 PECOS PAC ID: 7517081078 Enrollment ID: I20100907000076 |
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