Organization
STEVEN M DIVACK, M.D., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEVEN M DIVACK M.D. (PRESIDENT)
(718) 638-8484
Entity
Organization
Contact information
Practice address
115 EASTERN PKWY, BROOKLYN, NY 11238-6085
(718) 638-8484
(718) 638-8588
Mailing address
115 EASTERN PKWY, BROOKLYN, NY 11238-6085
(718) 638-8484
(718) 638-8588
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
143879
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00523744
—
NY
Enumeration date
12/13/2011
Last updated
12/13/2011
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