Organization
OMER TIPU PHYSICIAN PC
Active
Organization
OMER TIPU PHYSICIAN PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OMER TIPU MD (PRESIDENT)
(718) 972-4200
Entity
Organization
Contact information
Practice address
446 MCDONALD AVE, BROOKLYN, NY 11218-2212
(718) 972-4200
Mailing address
710 SUNNYVIEW OVAL, KEASBEY, NJ 08832-1039
(718) 972-4200
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03850084
—
NY
Enumeration date
04/23/2014
Last updated
08/01/2014
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