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Organization

BRIDGE TO HEALTH MEDICAL P.C

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. ILYA SMUGLIN (PRESIDENT)
(347) 598-4898
Entity
Organization

Contact information

Practice address
2565 E 17TH ST, BROOKLYN, NY 11235-3515
(347) 598-4898
Mailing address
2565 E 17TH ST, BROOKLYN, NY 11235-3515
(347) 598-4898

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
221943
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02754350
NY
Enumeration date
12/20/2007
Last updated
12/20/2007
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