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Organization
BLUE GREEN HORIZONS OFFICE BASED SURGERY PLLC
Active
Organization
BLUE GREEN HORIZONS OFFICE BASED SURGERY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHELBY K. SAMUEL M.D. (OWNER)
(718) 498-7888
Entity
Organization
Contact information
Practice address
200 BROOKLYN AVE, BROOKLYN, NY 11213-1908
(718) 498-7888
(718) 604-7890
Mailing address
200 BROOKLYN AVE, BROOKLYN, NY 11213-1908
(718) 498-7888
(718) 604-7890
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
176352
NY
Other
Enumeration date
02/23/2010
Last updated
02/23/2010
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