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Organization
ULTIMATE PRIMARY CARE PC
Active
Organization
ULTIMATE PRIMARY CARE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SALLY ABOUEL-ELA M.D. (OWNER)
(718) 833-4742
Entity
Organization
Contact information
Practice address
9711 3RD AVE, BSMT LEVEL, BROOKLYN, NY 11209-7702
(718) 833-4742
(718) 836-4629
Mailing address
254 BIRCHWOOD PARK DR, JERICHO, NY 11753-2307
(718) 833-4742
(718) 836-4629
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
238713
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03080206
—
NY
Enumeration date
03/08/2010
Last updated
10/19/2010
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