Organization
PARK AVE AMBULATORY MEDICAL FACILITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VADIM KUSHNERIK MD (SURGICAL DIRECTOR)
(718) 422-5023
Entity
Organization
Contact information
Practice address
360 COURT ST, SUITE# 3, BROOKLYN, NY 11231-4353
(718) 422-5023
(718) 422-5025
Mailing address
360 COURT ST, SUITE# 3, BROOKLYN, NY 11231-4353
(718) 422-5023
(718) 422-5025
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
217486
NY
Other
Enumeration date
05/22/2008
Last updated
05/22/2008
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