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Organization
OMICRON MEDICAL PC
Active
Organization
OMICRON MEDICAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ILYA BURSHTEYN (MD)
(718) 459-3494
Entity
Organization
Contact information
Practice address
10525 64TH AVE, FOREST HILLS, NY 11375-1640
(718) 459-3494
(718) 606-6069
Mailing address
10525 64TH AVE, FOREST HILLS, NY 11375-1640
(718) 459-3494
(718) 606-6069
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2156381
NY
213E00000X
Podiatrist
N0060751
NY
Other
Enumeration date
05/11/2017
Last updated
05/11/2017
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