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Organization

TRISTATE MEDICAL CARE PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. SHASHIBALA SONI (MD FACP FACC)
(718) 236-4444
Entity
Organization

Contact information

Practice address
3615 AVE S, BROOKLYN, NY 11234
(718) 336-2110
Mailing address
8200 21ST AVE, BROOKLYN, NY 11214
(718) 236-6644
(718) 236-9080

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
128754
NY
207RC0000X
Cardiovascular Disease Physician
Primary
128754
NY
261QP2300X
Primary Care Clinic/Center
128754
NY
261QP2300X
Primary Care Clinic/Center
25MA06036700
NJ

Other

Enumeration date
10/14/2006
Last updated
01/16/2008
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