Organization
EAW MEDICAL CARE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EVERTON PROSPERE M.D. (MEDICAL DOCTOR)
(917) 207-6792
Entity
Organization
Contact information
Practice address
612 SCHENECTADY AVE, BROOKLYN, NY 11203-1821
(917) 207-6792
Mailing address
612 SCHENECTADY AVE, BROOKLYN, NY 11203-1821
(917) 207-6792
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
226783
NY
Other
Enumeration date
07/21/2008
Last updated
04/17/2009
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