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Organization
SEAGULL MEDICAL SERVICES
Active
Organization
SEAGULL MEDICAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ILYA SMUGLIN MD (OWNER)
(929) 327-2566
Entity
Organization
Contact information
Practice address
105 NORWALK AVE, STATEN ISLAND, NY 10314-5658
(929) 574-1629
Mailing address
368 77TH ST, BROOKLYN, NY 11209-3110
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
NULL
Other
Enumeration date
11/08/2018
Last updated
11/15/2018
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