Organization
BRIGHTON MEDICAL PRACTICE P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHILA MOMTAJ (MANAGER)
(718) 368-3092
Entity
Organization
Contact information
Practice address
706 BANNER AVE, BROOKLYN, NY 11235-6957
(718) 368-3092
(718) 368-2051
Mailing address
706 BANNER AVE, BROOKLYN, NY 11235-6957
(718) 368-3092
(718) 368-2051
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02743364
—
NY
Enumeration date
10/17/2019
Last updated
04/14/2021
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