Provider Demographics
NPI:1710001862
Name:SYNERGY MEDICAL PRACTICE PC
Entity Type:Organization
Organization Name:SYNERGY MEDICAL PRACTICE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER-DOCTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:H
Authorized Official - Last Name:DELMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-435-9745
Mailing Address - Street 1:3907 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11232-2901
Mailing Address - Country:US
Mailing Address - Phone:718-435-9745
Mailing Address - Fax:718-435-9746
Practice Address - Street 1:3907 4TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11232-2901
Practice Address - Country:US
Practice Address - Phone:718-435-9745
Practice Address - Fax:718-435-9746
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY164099174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1902966021OtherRAJ D. TOLAT, M.D.
NY1902966021OtherRAJ D. TOLAT, M.D.
NY23J091Medicare ID - Type UnspecifiedDAVID H. DELMAN, M.D.