Organization
AVE J MEDICAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEONID E TAFLER D.O. (ADMIN)
(718) 338-1166
Entity
Organization
Contact information
Practice address
4010 AVENUE J, BROOKLYN, NY 11210-4440
(718) 338-1166
(718) 951-7550
Mailing address
4010 AVENUE J, BROOKLYN, NY 11210-4440
(718) 338-1166
(718) 951-7550
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
212382
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01906270
—
NY
01
—
212382
LICENSE
NY
01
—
33D0963294
CLIA #
NY
Enumeration date
11/10/2008
Last updated
03/07/2023
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