Organization
MEDICAL CARE OF KINGSBOROUGH PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EWALD ANTOINE MD (PRESIDENT)
(718) 513-6440
Entity
Organization
Contact information
Practice address
2297 CONEY ISLAND AVE, BROOKLYN, NY 11223-3337
(718) 513-6440
(718) 975-2085
Mailing address
2297 CONEY ISLAND AVE, BROOKLYN, NY 11223-3337
(718) 513-6440
(718) 975-2085
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
—
—
2084P0805X
Geriatric Psychiatry Physician
Primary
—
—
213EP1101X
Primary Podiatric Medicine Podiatrist
—
—
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01644706
—
NY
01
—
167153
LICENSE
—
Enumeration date
12/06/2012
Last updated
12/06/2012
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