Provider Demographics
NPI:1619362803
Name:DOCTOR'S MEDICAL P.C
Entity Type:Organization
Organization Name:DOCTOR'S MEDICAL P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:AHMED
Authorized Official - Middle Name:E
Authorized Official - Last Name:ELEMAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-769-4988
Mailing Address - Street 1:2968 AVENUE X
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-1808
Mailing Address - Country:US
Mailing Address - Phone:718-769-4988
Mailing Address - Fax:718-769-4415
Practice Address - Street 1:2968 AVENUE X
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-1808
Practice Address - Country:US
Practice Address - Phone:718-769-4988
Practice Address - Fax:718-769-4415
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-03
Last Update Date:2015-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY199870-4174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty