# 1771 UTICA LLC

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

## Provider details

- **NPI number:** 1881530285
- **Authorized official:** MR. DANIL SHABATAY (PRESIDENT./CEO)
- **Authorized official phone:** (917) 933-4333

## Contact information

- **Practice address:** 1771 UTICA AVE, BROOKLYN, NY 11234-2120
- **Practice address phone:** (917) 933-4333
- **Practice address fax:** (917) 933-4330
- **Mailing address:** 1771 UTICA AVE, BROOKLYN, NY 11234-2120
- **Mailing address phone:** (917) 933-4333
- **Mailing address fax:** (917) 933-4330

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 207RC0000X | Cardiovascular Disease Physician | — | NULL | — |
| 207RC0000X | Cardiovascular Disease Physician | — | — | — |

## Other

- **Enumeration date:** 04/27/2026
- **Last updated:** 05/20/2026