Individual
S BRENT RIDGE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1470 MADISON AVE, NEW YORK, NY 10029
(212) 659-8552
Mailing address
ONE GUSTAVE L LEVY PLACE, BOX 1070, NEW YORK, NY 10029
(212) 241-5561
(212) 860-9737
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
2189471
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
D2554718
—
NY
Enumeration date
02/27/2006
Last updated
07/08/2007
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