Organization
PROHEALTHLIFE MEDICAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAJENDRA DAMODAR BHAYANI MD (PRESIDENT)
(718) 249-9383
Entity
Organization
Contact information
Practice address
1783 W 6TH ST, BROOKLYN, NY 11223-1321
(718) 645-2555
Mailing address
1783 W 6TH ST, BROOKLYN, NY 11223-1321
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
011734
NY
Other
Enumeration date
08/19/2013
Last updated
08/19/2013
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