Provider Demographics
NPI:1346006202
Name:MILL BASIN MEDICAL HEALTH PC
Entity Type:Organization
Organization Name:MILL BASIN MEDICAL HEALTH PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MAYER
Authorized Official - Middle Name:
Authorized Official - Last Name:SPILMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-269-1508
Mailing Address - Street 1:1583 E 66TH ST FL 1
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-6005
Mailing Address - Country:US
Mailing Address - Phone:917-318-4724
Mailing Address - Fax:
Practice Address - Street 1:1583 E 66TH ST FL 1
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-6005
Practice Address - Country:US
Practice Address - Phone:917-318-4724
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-27
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative MedicineGroup - Multi-Specialty