Provider Demographics
NPI:1285676635
Name:HARTFORD MEDICAL PC
Entity Type:Organization
Organization Name:HARTFORD MEDICAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING EMPLOYEE
Authorized Official - Prefix:MR
Authorized Official - First Name:MOHAMED
Authorized Official - Middle Name:H
Authorized Official - Last Name:BEDEWI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-499-6590
Mailing Address - Street 1:PO BOX 2215
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10101-2215
Mailing Address - Country:US
Mailing Address - Phone:718-499-6590
Mailing Address - Fax:718-499-6594
Practice Address - Street 1:406 15TH ST
Practice Address - Street 2:SUITE M-2
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-6054
Practice Address - Country:US
Practice Address - Phone:718-499-6590
Practice Address - Fax:718-499-6594
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-11
Last Update Date:2010-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Single Specialty