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Organization

EVERGREEN MEDICAL PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MISS MAY LIN (OFFICE MANAGER)
(718) 680-8881
Entity
Organization

Contact information

Practice address
755-759 61ST STREET, BROOKLYN, NY 11220-4211
(718) 680-8881
(718) 680-7880
Mailing address
755-759 61ST STREET, BROOKLYN, NY 11220-4211
(718) 680-8881
(718) 680-7880

Taxonomy

Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
207RR0500X
Rheumatology Physician
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
2084N0400X
Neurology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02440279
NY
05
02681267
NY
05
03032428
NY
05
03036766
NY
Enumeration date
03/30/2009
Last updated
06/03/2009
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