Organization
NORTH BROADWAY MEDICAL P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GRIGORY SHTENDER M.D (INCORPORATOR/PRESIDENT)
(718) 336-1242
Entity
Organization
Contact information
Practice address
1723 E 12TH ST, SUITE 5L, BROOKLYN, NY 11229-1069
(718) 336-1242
(718) 336-1518
Mailing address
1723 E 12TH ST, SUITE 5L, BROOKLYN, NY 11229-1069
(718) 336-1242
(718) 336-1518
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
218261
NY
Other
Enumeration date
07/30/2012
Last updated
07/30/2012
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