# ALLA SHUSTAROVICH MD PC

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

## Provider details

- **NPI number:** 1245509454
- **Authorized official:** ALLA SHUSTAROVICH (MD)
- **Authorized official phone:** (718) 332-7411

## Contact information

- **Practice address:** 99 BRIGHTON 11 STREET, BROOKLYN, NY 11235
- **Practice address phone:** (718) 332-7411
- **Practice address fax:** (718) 332-7412
- **Mailing address:** 99 BRIGHTON 11 STREET, BROOKLYN, NY 11235
- **Mailing address phone:** (718) 332-7411
- **Mailing address fax:** (718) 332-7412

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | 203553 | NY | Yes |

## Other

- **Enumeration date:** 12/16/2011
- **Last updated:** 12/16/2011