Organization
BROOKLYN AVENUE MEDICAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHELBY KEVIN SAMUEL M.D. (MEDICAL DIRECTOR)
(718) 498-7888
Entity
Organization
Contact information
Practice address
200 BROOKLYN AVE, BROOKLYN, NY 11213-1908
(718) 498-7888
(718) 604-7890
Mailing address
200 BROOKLYN AVE, BROOKLYN, NY 11213-1908
(718) 498-7888
(718) 604-7890
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Enumeration date
08/03/2015
Last updated
08/03/2015
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