# ADVANCED WOUND CARE MEDICAL PC

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

## Provider details

- **NPI number:** 1699726315
- **Authorized official:** DR. SERGEI KOCHLATYI M.D. (MEDICAL DIRECTOR)
- **Authorized official phone:** (718) 382-3400

## Contact information

- **Practice address:** 454 AVENUE U, BROOKLYN, NY 11223-4011
- **Practice address phone:** (718) 382-3400
- **Practice address fax:** (718) 382-3420
- **Mailing address:** 454 AVENUE U, BROOKLYN, NY 11223-4011
- **Mailing address phone:** (718) 382-3400
- **Mailing address fax:** (718) 382-3420

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | 218265 | NY | Yes |
| 208600000X | Surgery Physician | 087860 | NY | — |
| 208600000X | Surgery Physician | 150869 | NY | — |
| 208D00000X | General Practice Physician | 156598 | NY | — |
| 208D00000X | General Practice Physician | 227059 | NY | — |

## Other

- **Enumeration date:** 05/15/2006
- **Last updated:** 10/17/2007