Individual
MAN S OH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
451 CLARKSON AVE, BROOKLYN, NY 11203
(718) 270-1565
Mailing address
138 WHEATLEY RD, OLD WESTBURY, NY 11568
(718) 781-7444
(865) 342-0068
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
109765
NY
Other
Enumeration date
05/01/2006
Last updated
07/08/2007
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