Provider Demographics
NPI:1972774990
Name:GOOD HEALTH MEDICAL OF BROOKLYN, P.C.
Entity Type:Organization
Organization Name:GOOD HEALTH MEDICAL OF BROOKLYN, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LEO
Authorized Official - Middle Name:
Authorized Official - Last Name:YANKILEVICH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-645-9236
Mailing Address - Street 1:2026 OCEAN AVE
Mailing Address - Street 2:SUITE 1B
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-7352
Mailing Address - Country:US
Mailing Address - Phone:718-645-9236
Mailing Address - Fax:
Practice Address - Street 1:2026 OCEAN AVE
Practice Address - Street 2:SUITE 1B
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-7352
Practice Address - Country:US
Practice Address - Phone:718-645-9236
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-18
Last Update Date:2008-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY199964207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1018720OtherFIDELIS CARE
NY432740NOtherCIGNA
NY87093OtherAETNA
NY01601192Medicaid
NY199964OtherHIP
NY2C9154OtherHEALTHNET
NY005908OtherMETROPLUS
NY45J051OtherBCBS
NY137603OtherWELCARE
NYP683045OtherOXFORD
NYN130940Other1199
NY10111OtherELDERPALN
NY2597940OtherGHI
NY45J051OtherMAGNACARE
NY137603OtherWELCARE