NPI Provider: 1861413981
Contact Name: Petrychenko Dmitri
Position: President
Phone: (718) 336-5123
Petrychenko Physician Pc Information:
Petrychenko Physician Pc organization have npi 1861413981, taxonomy code is 174400000X with license number is in . This Business address located in 1660 E 14th St, Brooklyn, NY 11229 New York.
Practice Location
Address: 1660 E 14th St, Brooklyn, NY 11229
Phone: (718) 336-5123
Business Location
Address: 1660 E 14th St, Brooklyn, NY 11229
Phone: (718) 336-5123
Fax: (718) 336-5137
Taxonomy
Taxonomy Code: 174400000X
License Number:
License Number of State:
Primary Taxonomy Switch: Y
Enumeration Date: 7/22/2006
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