Provider Demographics
NPI:1356302343
Name:PROFESSIONAL MEDICAL ARTS, P.C.
Entity Type:Organization
Organization Name:PROFESSIONAL MEDICAL ARTS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIKA
Authorized Official - Middle Name:DANIELLE
Authorized Official - Last Name:CHERFAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-769-1010
Mailing Address - Street 1:1170 BRIGHTON BEACH AVE
Mailing Address - Street 2:SUITE 1CC
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-5901
Mailing Address - Country:US
Mailing Address - Phone:718-769-1010
Mailing Address - Fax:718-648-5669
Practice Address - Street 1:1170 BRIGHTON BEACH AVE
Practice Address - Street 2:SUITE 1CC
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-5901
Practice Address - Country:US
Practice Address - Phone:718-769-1010
Practice Address - Fax:718-648-5669
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY203703207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01675369Medicaid
NY01675369Medicaid
NY01675369Medicaid
NY=========OtherTIN