Basic Information
| Provider Information | |||||||||
| NPI: | 1528471828 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | BRIGHTON MEDICAL CARE NY PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1009 BRIGHTON BEACH AVE STE 2 | ||||||||
| Address2: | |||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 112355621 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7189758500 | ||||||||
| FaxNumber: | 7189758502 | ||||||||
| Practice Location | |||||||||
| Address1: | 1009 BRIGHTON BEACH AVE STE 2 | ||||||||
| Address2: | |||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 112355621 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7189758500 | ||||||||
| FaxNumber: | 7189754337 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/04/2014 | ||||||||
| LastUpdateDate: | 03/15/2016 | ||||||||
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| AuthorizedOfficialLastName: | VOLOVOY | ||||||||
| AuthorizedOfficialFirstName: | VITALY | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWENER | ||||||||
| AuthorizedOfficialTelephone: | 7189758500 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208D00000X | 205549 | NY | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | General Practice |
No ID Information.