Provider Demographics
NPI:1629025341
Name:B R SALES MD PC
Entity Type:Organization
Organization Name:B R SALES MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INTERNIST
Authorized Official - Prefix:DR
Authorized Official - First Name:BENIGNO
Authorized Official - Middle Name:REYES
Authorized Official - Last Name:SALES
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:718-738-2222
Mailing Address - Street 1:8405 164TH AVE
Mailing Address - Street 2:
Mailing Address - City:HOWARD BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11414-3613
Mailing Address - Country:US
Mailing Address - Phone:718-845-5839
Mailing Address - Fax:718-835-6014
Practice Address - Street 1:14218 38TH AVE APT CFD
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-5554
Practice Address - Country:US
Practice Address - Phone:718-886-2288
Practice Address - Fax:718-886-1179
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY119359261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYC10739Medicare UPIN