Organization
AJS BROOKLYN MEDICAL PRACTICE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONNA STIDHAM (CHIEF, MANAGED CARE)
(323) 436-5025
Entity
Organization
Contact information
Practice address
655 MORRIS AVE # 2, BRONX, NY 10451-4898
(347) 736-9046
Mailing address
6255 W SUNSET BLVD FL 21, LOS ANGELES, CA 90028-7422
(323) 436-5025
(833) 241-7615
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
05/17/2019
Last updated
09/11/2019
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