Organization
CITYBLOCK MEDICAL PRACTICE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN BROWN (CHIEF ADMINISTRATIVE OFFICER)
(833) 904-0620
Entity
Organization
Contact information
Practice address
6100 E MAIN ST STE 110, COLUMBUS, OH 43213-3399
(833) 904-0620
Mailing address
495 FLATBUSH AVE STE C5, BROOKLYN, NY 11225-3706
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
11/16/2021
Last updated
01/19/2023
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