# BAY 29 MEDICAL PC

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

## Provider details

- **NPI number:** 1407080880
- **Authorized official:** DR. CHITRE NITIN PRABHAKAR MD (OWNER)
- **Authorized official phone:** (718) 758-4520

## Contact information

- **Practice address:** 174 BAY 29TH ST, BROOKLYN, NY 11214-5020
- **Practice address phone:** (718) 758-4520
- **Mailing address:** 174 BAY 29TH STREET, BROOKLYN, NY 11214
- **Mailing address phone:** (718) 758-4520

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 2002782 | NY | Yes |

## Other

- **Enumeration date:** 05/13/2009
- **Last updated:** 05/13/2009