Organization
COLORECTAL CARE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MYCHAILO FULMES MD (SOLE MBR)
(718) 743-4450
Entity
Organization
Contact information
Practice address
2647 CONEY ISLAND AVE, BROOKLYN, NY 11223-5502
(718) 743-4450
Mailing address
7000 BAY PKWY, BROOKLYN, NY 11204-5531
(718) 743-4450
Taxonomy
Speciality
Code
Description
License number
State
208C00000X
Colon & Rectal Surgery Physician
Primary
—
—
Other
Enumeration date
05/06/2014
Last updated
05/06/2014
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