Organization
OMNI MEDICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EVANS CREVECOEUR M.D. (PRESIDENT)
(718) 433-0044
Entity
Organization
Contact information
Practice address
765 NOSTRAND AVE, BROOKLYN, NY 11216-4203
(718) 433-0044
(718) 433-4644
Mailing address
765 NOSTRAND AVE, BROOKLYN, NY 11216-4203
(718) 433-0044
(718) 433-4644
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
10/21/2016
Last updated
10/21/2016
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