# FAITH FAMILY MEDICAL PC

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

## Provider details

- **NPI number:** 1598878167
- **Authorized official:** DR. JEAN-ETIENNE THIBAUD DO (PRESIDENT)
- **Authorized official phone:** (718) 531-6100

## Contact information

- **Practice address:** 1713-19 RALPH AVENUE, BROOKLYN, NY 11236
- **Practice address phone:** (718) 531-6100
- **Practice address fax:** (718) 531-2329
- **Mailing address:** PO BOX 100714, VANDERVEER STATION, BROOKLYN, NY 11210-0714
- **Mailing address phone:** (718) 531-6100
- **Mailing address fax:** (718) 531-2329

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 224277 | NY | Yes |

## Other

- **Enumeration date:** 08/16/2006
- **Last updated:** 08/22/2020