Provider Demographics
NPI:1114190402
Name:MEGA MEDICAL CONSALTANTS PC
Entity Type:Organization
Organization Name:MEGA MEDICAL CONSALTANTS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:IRENE
Authorized Official - Middle Name:
Authorized Official - Last Name:GLADSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-382-7900
Mailing Address - Street 1:2076 E 13TH ST
Mailing Address - Street 2:1ST FL
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-3304
Mailing Address - Country:US
Mailing Address - Phone:718-382-7900
Mailing Address - Fax:718-382-7901
Practice Address - Street 1:2076 E 13TH ST
Practice Address - Street 2:1ST FL
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-3304
Practice Address - Country:US
Practice Address - Phone:718-382-7900
Practice Address - Fax:718-382-7901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-08
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY229431261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center