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Organization
PROSPECT MEDICAL CARE PC
Active
Organization
PROSPECT MEDICAL CARE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LARISA V MASHENSKY MD (PRESIDENT)
(718) 998-3020
Entity
Organization
Contact information
Practice address
560 PROSPECT AVE, BRONX, NY 10455-4403
(718) 402-0700
(718) 292-4800
Mailing address
1656 E 12TH ST, BROOKLYN, NY 11229-1012
(718) 998-3020
(718) 998-9059
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
X00408362
NY
207R00000X
Internal Medicine Physician
Primary
223084
NY
225100000X
Physical Therapist
029079
NY
Other
Enumeration date
09/23/2010
Last updated
01/05/2012
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