Organization
CHURCH-MCDONALD MEDICAL DIAGNOSTIC PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TINA SHALLONIS (BILLING MANAGER)
(352) 399-5085
Entity
Organization
Contact information
Practice address
486 MCDONALD AVE, BROOKLYN, NY 11432
(352) 399-5085
(866) 402-3481
Mailing address
486 MCDONALD AVE, BROOKLYN, NY 11432
(352) 399-5085
(866) 402-3481
Taxonomy
Speciality
Code
Description
License number
State
261QP3300X
Pain Clinic/Center
Primary
239768
NY
Other
Enumeration date
05/24/2016
Last updated
05/24/2016
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