Organization
BUSHWICK PROFESSIONAL MEDICAL SERVICES OF NEW YORK LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
YAN KATSNELSON (OWNER)
(224) 318-0118
Entity
Organization
Contact information
Practice address
441 KNICKERBOCKER AVE STE A, BROOKLYN, NY 11237-4508
(347) 773-2684
(718) 261-3893
Mailing address
PO BOX 32, NORTHBROOK, IL 60065-0032
(847) 593-8460
(224) 235-4652
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
—
—
Other
Enumeration date
07/20/2018
Last updated
07/20/2018
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