Provider Demographics
NPI:1497634513
Name:1578 MEDICAL HEALTHCARE P.C.
Entity type:Organization
Organization Name:1578 MEDICAL HEALTHCARE P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KAMAL
Authorized Official - Middle Name:
Authorized Official - Last Name:TADROS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-697-3799
Mailing Address - Street 1:PO BOX 70801A
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11207-0925
Mailing Address - Country:US
Mailing Address - Phone:516-697-3799
Mailing Address - Fax:
Practice Address - Street 1:1578 WILLIAMSBRIDGE RD STE 2D
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-6266
Practice Address - Country:US
Practice Address - Phone:718-360-5548
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-02
Last Update Date:2025-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty