Organization
WYCKOFF DOCTORS
Active
Parent organization
WYCKOFF PROFESSIONAL MEDICAL SERVICES PC
Organization subpart
Yes
Provider details
NPI number
Legal business name
WYCKOFF PROFESSIONAL MEDICAL SERVICES PC
Authorized official
MR. FRANK VUTRANO (CHIEF FINANCIAL OFFICER)
(718) 963-6702
Entity
Organization
Contact information
Practice address
1610 DEKALB AVENUE, WYCKOFF DOCTORS, BROOKLYN, NY 11237-3906
(718) 963-7676
(718) 963-6667
Mailing address
374 STOCKHOLM STREET, WYCKOFF PROFESSIONAL MEDICAL SERVICES, PC - FACULTY PRA, BROOKLYN, NY 11237-4006
(718) 963-7676
(718) 963-6667
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03722025
—
NY
Enumeration date
05/28/2015
Last updated
08/20/2016
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