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Organization
WYCKOFF FAMILY MEDICAL SERVICES P C
Active
Organization
WYCKOFF FAMILY MEDICAL SERVICES P C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FARIDEH ZONOUZI-ZADEH M.D. (DIRECTOR/OFFICER)
(718) 963-6485
Entity
Organization
Contact information
Practice address
374 STOCKHOLM ST, C/O FACULTY PRACTICE MANAGEMENT- SUITE 1-37 N, BROOKLYN, NY 11237-4006
(718) 963-6485
(718) 963-6793
Mailing address
374 STOCKHOLM ST, C/O FACULTY PRACTICE MANAGEMENT- SUITE 1-37 N, BROOKLYN, NY 11237-4006
(718) 963-6485
(718) 963-6793
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03313540
—
NY
Enumeration date
06/01/2006
Last updated
05/30/2013
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