# BUSHWICK PROFESSIONAL MEDICAL SERVICES OF NEW YORK LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003393299
- **Authorized official:** YAN KATSNELSON (OWNER)
- **Authorized official phone:** (224) 318-0118

## Contact information

- **Practice address:** 441 KNICKERBOCKER AVE STE A, BROOKLYN, NY 11237-4508
- **Practice address phone:** (347) 773-2684
- **Practice address fax:** (718) 261-3893
- **Mailing address:** PO BOX 32, NORTHBROOK, IL 60065-0032
- **Mailing address phone:** (847) 593-8460
- **Mailing address fax:** (224) 235-4652

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2086S0129X | Vascular Surgery Physician | — | NULL | Yes |
| 2086S0129X | Vascular Surgery Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/20/2018
- **Last updated:** 07/20/2018