Provider Demographics
NPI:1396026753
Name:NORTH FLATBUSH MEDICAL PC
Entity Type:Organization
Organization Name:NORTH FLATBUSH MEDICAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YONG
Authorized Official - Middle Name:
Authorized Official - Last Name:CHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-576-6565
Mailing Address - Street 1:1353 UTICA AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11203-6615
Mailing Address - Country:US
Mailing Address - Phone:718-576-6565
Mailing Address - Fax:
Practice Address - Street 1:1353 UTICA AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203-6615
Practice Address - Country:US
Practice Address - Phone:718-576-6565
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-30
Last Update Date:2011-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY243073208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty