Basic Information
| Provider Information | |||||||||
| NPI: | 1548506884 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HEALTH 4 U MEDICAL PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1009 BRIGHTON BEACH AVE | ||||||||
| Address2: | SUITE 302 | ||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 112355659 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7189750657 | ||||||||
| FaxNumber: | 7189750659 | ||||||||
| Practice Location | |||||||||
| Address1: | 1009 BRIGHTON BEACH AVE | ||||||||
| Address2: | SUITE 302 | ||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 112355659 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7189750657 | ||||||||
| FaxNumber: | 7189750659 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/13/2012 | ||||||||
| LastUpdateDate: | 12/13/2012 | ||||||||
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| AuthorizedOfficialLastName: | ZWITIASHVILI | ||||||||
| AuthorizedOfficialFirstName: | ROBERT | ||||||||
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| AuthorizedOfficialTitleorPosition: | MANAGING MEMBER | ||||||||
| AuthorizedOfficialTelephone: | 7189750657 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 160217 | NY | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.