Organization
CONEY ISLAND MEDICAL PRACTICE PLAN, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUDHA PENTYALA (DIRECTOR)
(631) 675-9300
Entity
Organization
Contact information
Practice address
2601 OCEAN PKWY, BROOKLYN, NY 11235-7745
(718) 616-5354
(718) 579-6060
Mailing address
234 E 149TH ST, BRONX, NY 10451-5504
(718) 579-6017
(718) 579-6060
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
09/08/2010
Last updated
09/22/2010
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