| Jal 28 Llc | |
|
2873 W 17th St Brooklyn NY 11224-2611 | |
| (718) 265-0900 | |
| Not Available |
| Full Name | Jal 28 Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2873 W 17th St, Brooklyn, New York |
| Authorized Official Name and Position | John Lieberman (MANAGER) |
| Authorized Official Contact | 9177477976 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jal 28 Llc 2873 W 17th St Brooklyn NY 11224-2611 Ph: () - | Jal 28 Llc 2873 W 17th St Brooklyn NY 11224-2611 Ph: (718) 265-0900 |
| NPI Number | 1063278281 |
|---|---|
| Provider Enumeration Date | 02/26/2024 |
| Last Update Date | 02/26/2024 |
| Medicare PECOS PAC ID | 5193262830 |
|---|---|
| Medicare Enrollment ID | O20240731000953 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063278281 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Cesare Saponieri |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1760436885 PECOS PAC ID: 8022005008 Enrollment ID: I20040429001606 |
| Provider Name | Michael J Gladstein |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1104848811 PECOS PAC ID: 4486637022 Enrollment ID: I20040612000370 |
| Provider Name | Thresiamma S Nidhiry |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1134145683 PECOS PAC ID: 2961480843 Enrollment ID: I20040708000356 |
| Provider Name | Yefim Vaynshelbaum |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1255361283 PECOS PAC ID: 3274501572 Enrollment ID: I20040923001155 |
| Provider Name | Konstantin Vaizman |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1639268105 PECOS PAC ID: 8921009234 Enrollment ID: I20070129000430 |
| Provider Name | Glenn J Donovan |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1700950839 PECOS PAC ID: 2264534403 Enrollment ID: I20070219000696 |
| Provider Name | Swaminathan Giridharan |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1578530770 PECOS PAC ID: 5890857130 Enrollment ID: I20081222000255 |
| Provider Name | Ngozi J Udeh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1043546781 PECOS PAC ID: 4789713603 Enrollment ID: I20100602000195 |
| Provider Name | Sabrina Budden-wright |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376205856 PECOS PAC ID: 0749674711 Enrollment ID: I20221228000596 |
| Provider Name | Elina Davidov |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073937413 PECOS PAC ID: 2163884685 Enrollment ID: I20230816001118 |
| Provider Name | Leonid Isakov |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1558558122 PECOS PAC ID: 2567509094 Enrollment ID: I20240619001978 |
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