Provider Demographics
NPI:1922409754
Name:BROOKLYN MEDICAL & SURGICAL PLLC
Entity Type:Organization
Organization Name:BROOKLYN MEDICAL & SURGICAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:NORMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SVEILICH
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:917-525-3067
Mailing Address - Street 1:1575 E 19TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-7203
Mailing Address - Country:US
Mailing Address - Phone:917-325-0349
Mailing Address - Fax:201-389-3498
Practice Address - Street 1:1575 E 19TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-7203
Practice Address - Country:US
Practice Address - Phone:917-325-0349
Practice Address - Fax:201-389-3498
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-11
Last Update Date:2014-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY5095261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY5095OtherAAAASF