Provider Demographics
NPI:1679115372
Name:MIDWOOD NEPHROLOGY CARE PLLC
Entity Type:Organization
Organization Name:MIDWOOD NEPHROLOGY CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:YANA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHTERN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-209-9990
Mailing Address - Street 1:255 ARKANSAS DR
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-6901
Mailing Address - Country:US
Mailing Address - Phone:917-209-9990
Mailing Address - Fax:718-228-2680
Practice Address - Street 1:1915 OCEAN AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-6801
Practice Address - Country:US
Practice Address - Phone:718-258-7700
Practice Address - Fax:718-228-2680
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-14
Last Update Date:2019-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty