Organization
ALLA SHUSTAROVICH MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALLA SHUSTAROVICH (MD)
(718) 332-7411
Entity
Organization
Contact information
Practice address
99 BRIGHTON 11 STREET, BROOKLYN, NY 11235
(718) 332-7411
(718) 332-7412
Mailing address
99 BRIGHTON 11 STREET, BROOKLYN, NY 11235
(718) 332-7411
(718) 332-7412
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
203553
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01665952
—
NY
Enumeration date
12/16/2011
Last updated
12/16/2011
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