Provider Demographics
NPI:1518132372
Name:MEDICAL CARE PLLC
Entity Type:Organization
Organization Name:MEDICAL CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ARKADIY
Authorized Official - Middle Name:
Authorized Official - Last Name:IZRAILOV
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-438-0707
Mailing Address - Street 1:4819 14TH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11219-3166
Mailing Address - Country:US
Mailing Address - Phone:718-438-0707
Mailing Address - Fax:718-438-8258
Practice Address - Street 1:4819 14TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11219-3166
Practice Address - Country:US
Practice Address - Phone:718-438-0707
Practice Address - Fax:718-438-8258
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-23
Last Update Date:2008-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY218546207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02083549Medicaid
NY02083549Medicaid