Provider Demographics
NPI:1326879347
Name:TOTAL MEDICAL KIDNEY CARE PC
Entity type:Organization
Organization Name:TOTAL MEDICAL KIDNEY CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARIE-ALEX
Authorized Official - Middle Name:
Authorized Official - Last Name:MICHEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:347-264-3929
Mailing Address - Street 1:PO BOX 255
Mailing Address - Street 2:
Mailing Address - City:BALDWIN
Mailing Address - State:NY
Mailing Address - Zip Code:11510-0255
Mailing Address - Country:US
Mailing Address - Phone:347-264-3929
Mailing Address - Fax:929-356-2100
Practice Address - Street 1:89 BARTLETT ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11206-4463
Practice Address - Country:US
Practice Address - Phone:347-264-3929
Practice Address - Fax:929-356-2100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-12
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty