# PROSPECT AVE. MEDICAL P.C.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Prospect Medical
- **Organization subpart:** No

## Provider details

- **NPI number:** 1942695275
- **Authorized official:** YURA STOLYARSKY (MEDICAL DIRECTOR)
- **Authorized official phone:** (718) 704-9909

## Contact information

- **Practice address:** 3049 OCEAN PKWY FL 2, BROOKLYN, NY 11235
- **Practice address phone:** (718) 704-9909
- **Practice address fax:** (347) 702-5419
- **Mailing address:** PO BOX 230384, BROOKLYN, NY 11223-0384
- **Mailing address phone:** (718) 704-9909
- **Mailing address fax:** (347) 702-5419

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | 275763 | NY | Yes |
| 261QP2000X | Physical Therapy Clinic/Center | 275763 | NY | — |
| 261QR0400X | Rehabilitation Clinic/Center | 275763 | NY | — |

## Other

- **Enumeration date:** 04/03/2015
- **Last updated:** 02/11/2020