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Organization

ADULT AND GERIATRIC MEDICAL CARE PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DIANA LEVINA MD (PRESIDENT)
(917) 609-5537
Entity
Organization

Contact information

Practice address
4802 10TH AVE FL 10, BROOKLYN, NY 11219-2916
(917) 609-5537
(718) 630-3761
Mailing address
157 BEAUMONT ST, BROOKLYN, NY 11235-4118
(917) 609-4748
(718) 630-3761

Taxonomy

Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
261Q00000X
Clinic/Center
234232
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
03416084
NY
Enumeration date
03/20/2007
Last updated
09/20/2022
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