Provider Demographics
NPI:1639367436
Name:BAY PARKWAY MEDICAL PC
Entity Type:Organization
Organization Name:BAY PARKWAY MEDICAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:TSINKER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-234-0009
Mailing Address - Street 1:7701 BAY PKWY
Mailing Address - Street 2:APT 1G
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11214-1541
Mailing Address - Country:US
Mailing Address - Phone:718-234-0009
Mailing Address - Fax:718-234-5164
Practice Address - Street 1:7701 BAY PKWY
Practice Address - Street 2:APT 1G
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11214-1541
Practice Address - Country:US
Practice Address - Phone:718-234-0009
Practice Address - Fax:718-234-5164
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-05
Last Update Date:2007-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY180136207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KP439OtherOXFORD
NY01351000Medicaid
KP439OtherOXFORD
NYE30209Medicare UPIN
NY01351000Medicaid