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Individual

DR. BRAZ BORTOT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
8728 SANTIAGO ST, HOLLIS, NY 11423-1120
(718) 740-0395
Mailing address
8728 SANTIAGO ST, HOLLIS, NY 11423-1120
(718) 740-0395

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
115972
NY

Other

Enumeration date
04/17/2009
Last updated
04/17/2009
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