Provider Demographics
NPI:1760733034
Name:HAMILTON MEDICAL PC
Entity Type:Organization
Organization Name:HAMILTON MEDICAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RICAROD
Authorized Official - Middle Name:N
Authorized Official - Last Name:SANTIAGO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-909-7041
Mailing Address - Street 1:8800 20TH AVE
Mailing Address - Street 2:APT 6L
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11214-4849
Mailing Address - Country:US
Mailing Address - Phone:347-909-7041
Mailing Address - Fax:
Practice Address - Street 1:6801 FORT HAMILTON PKWY
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11219-5856
Practice Address - Country:US
Practice Address - Phone:347-909-7041
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-27
Last Update Date:2012-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Multi-Specialty