Organization
1501 MEDICAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ILYA PAVLOV AKSELRUD MD (OWNER)
(718) 837-2660
Entity
Organization
Contact information
Practice address
1501 80TH ST STE 1, BROOKLYN, NY 11228-2533
(718) 837-2660
Mailing address
1501 80TH ST STE 1, BROOKLYN, NY 11228-2533
(718) 837-2660
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
09/02/2010
Last updated
09/02/2010
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