Individual
KERILL POCHETUHEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1220 AVENUE P, BROOKLYN, NY 11229-1009
(718) 376-1004
Mailing address
1305 KINGS HWY, BROOKLYN, NY 11229-1903
(718) 280-5172
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
284275
NY
Other
Enumeration date
07/25/2014
Last updated
11/12/2021
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