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Organization
INTERMED CARE PC
Active
Organization
INTERMED CARE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BORIS MAZUROV MD (MEDICAL DIRECTOR)
(718) 331-9600
Entity
Organization
Contact information
Practice address
721 FLUSHING AVE, BROOKLYN, NY 11206-4419
(718) 218-6888
(718) 218-6855
Mailing address
1849 86TH ST, BROOKLYN, NY 11214-3108
(718) 331-9600
(718) 331-9703
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03324018
—
NY
Enumeration date
08/22/2011
Last updated
09/16/2011
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