Provider Demographics
NPI:1841656857
Name:HERACLES MEDICAL PC
Entity type:Organization
Organization Name:HERACLES MEDICAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LAZAR
Authorized Official - Middle Name:I
Authorized Official - Last Name:FEYGIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-854-3005
Mailing Address - Street 1:198 FOSTER AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-2134
Mailing Address - Country:US
Mailing Address - Phone:718-854-3005
Mailing Address - Fax:718-854-9803
Practice Address - Street 1:2825 THIRD AVE
Practice Address - Street 2:SUITE 7
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10455
Practice Address - Country:US
Practice Address - Phone:718-854-3005
Practice Address - Fax:718-854-9803
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-06
Last Update Date:2016-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty