Organization
BLUE GREEN HORIZONS OFFICE BASED SURGERY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHELBY K. SAMUEL M.D. (OWNER)
(718) 498-7888
Entity
Organization
Contact information
Practice address
200 BROOKLYN AVE, BROOKLYN, NY 11213-1908
(718) 498-7888
(718) 604-7890
Mailing address
200 BROOKLYN AVE, BROOKLYN, NY 11213-1908
(718) 498-7888
(718) 604-7890
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
176352
NY
Other
Enumeration date
02/23/2010
Last updated
02/23/2010
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