Individual
ALLA SHUSTAROVICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
99 BRIGHTON 11 STR, BROOKLYN, NY 11235
(718) 332-7411
(718) 332-7412
Mailing address
244 W END AVE, BROOKLYN, NY 11235-4904
(718) 934-3636
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
02/15/2006
Last updated
12/27/2010
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