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Organization
PROSPECT AVE. MEDICAL P.C.
Active
Organization
PROSPECT AVE. MEDICAL P.C.
Active
Other names
Prospect Medical
Organization subpart
No
Provider details
NPI number
Authorized official
YURA STOLYARSKY (MEDICAL DIRECTOR)
(718) 704-9909
Entity
Organization
Contact information
Practice address
3049 OCEAN PKWY FL 2, BROOKLYN, NY 11235
(718) 704-9909
(347) 702-5419
Mailing address
PO BOX 230384, BROOKLYN, NY 11223-0384
(718) 704-9909
(347) 702-5419
Taxonomy
Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
275763
NY
261QP2000X
Physical Therapy Clinic/Center
275763
NY
261QR0400X
Rehabilitation Clinic/Center
275763
NY
Other
Enumeration date
04/03/2015
Last updated
02/11/2020
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