Organization
FLATBUSH MEDICAL PLAZA, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GRIGORY SHTENDER PHYSICIAN (PRESIDENT)
(917) 966-2700
Entity
Organization
Contact information
Practice address
1468 FLATBUSH AVE., BROOKLYN, NY 11210
(917) 966-2700
(917) 966-2703
Mailing address
1468 FLATBUSH AVE., BROOKLYN, NY 11210
(917) 966-2700
(917) 966-2703
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
218261
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02090619
—
NY
01
—
218261
LICENCE
NY
01
—
25MA07870200
LICENCE
NJ
Enumeration date
08/04/2014
Last updated
08/25/2014
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