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Organization
1771 UTICA LLC
Active
Organization
1771 UTICA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DANIL SHABATAY (PRESIDENT./CEO)
(917) 933-4333
Entity
Organization
Contact information
Practice address
1771 UTICA AVE, BROOKLYN, NY 11234-2120
(917) 933-4333
(917) 933-4330
Mailing address
1771 UTICA AVE, BROOKLYN, NY 11234-2120
(917) 933-4333
(917) 933-4330
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
207RC0000X
Cardiovascular Disease Physician
—
NULL
207RC0000X
Cardiovascular Disease Physician
—
—
Other
Enumeration date
04/27/2026
Last updated
05/20/2026
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