Organization
PRIME CARE ON THE BAY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELDAR KADYMOFF D.O. (MEDICAL DIRECTOR)
(718) 332-8002
Entity
Organization
Contact information
Practice address
1711 SHEEPSHEAD BAY RD, GROUND FLOOR, BROOKLYN, NY 11235-3651
(718) 332-8002
(718) 332-8006
Mailing address
1711 SHEEPSHEAD BAY RD, GROUND FLOOR, BROOKLYN, NY 11235-3651
(718) 332-8002
(718) 332-8006
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
7001106R
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02426653
—
NY
Enumeration date
10/30/2007
Last updated
10/31/2007
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