Organization
PROSPECT AVE. MEDICAL P.C.
Active
Other names
Prospect Medical
Organization subpart
No
Provider details
NPI number
Authorized official
YURA STOLYARSKY (MEDICAL DIRECTOR)
(718) 704-9909
Entity
Organization
Contact information
Practice address
3049 OCEAN PKWY FL 2, BROOKLYN, NY 11235
(718) 704-9909
(347) 702-5419
Mailing address
PO BOX 230384, BROOKLYN, NY 11223-0384
(718) 704-9909
(347) 702-5419
Taxonomy
Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
275763
NY
261QP2000X
Physical Therapy Clinic/Center
275763
NY
261QR0400X
Rehabilitation Clinic/Center
275763
NY
Other
Enumeration date
04/03/2015
Last updated
02/11/2020
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