Provider Demographics
NPI:1154993640
Name:MEDICAL ARTS FULL SERVICE P.C.
Entity type:Organization
Organization Name:MEDICAL ARTS FULL SERVICE P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:IRENA
Authorized Official - Middle Name:
Authorized Official - Last Name:PLESKOVA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:646-938-1921
Mailing Address - Street 1:2912 AVENUE X
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-1906
Mailing Address - Country:US
Mailing Address - Phone:347-570-5348
Mailing Address - Fax:718-676-6431
Practice Address - Street 1:2912 AVENUE X
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-1906
Practice Address - Country:US
Practice Address - Phone:347-570-5348
Practice Address - Fax:718-676-6431
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-14
Last Update Date:2021-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty