Organization
MOVE TOMORROW
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PROF. PTAH M. SHABAZZ-ST. CLAIRE PHD, DO (INTERN)
(929) 414-2960
Entity
Organization
Contact information
Practice address
1540 PITKIN AVE, BROOKLYN, NY 11212-4539
(929) 414-2960
Mailing address
369 HOWARD AVE, BROOKLYN, NY 11233-3939
(347) 779-1582
Taxonomy
Speciality
Code
Description
License number
State
261QC1800X
Corporate Health Clinic/Center
Primary
—
—
Other
Enumeration date
10/27/2021
Last updated
10/27/2021
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