| | Physician Last Name: | Omni Medical Care |
| | Physician First Name: | P.C. |
| | Physician Middle Name: | |
| | Address: | 2044 Ocean Avenue
Brooklyn, New York 11230 |
| | License Number: | 164820 |
| | License Type: | |
| | Year of Birth: |
|
| | Effective Date: | 07/03/2007 |
| | Action Description for DOH Webpage: | Revocation of Certificate of Incorporation. |
| | Misconduct Description for DOH Webpage: | The corporation failed to comply with sections fifteen hundred three and fifteen hundred fourteen of the business corporation law. |
| | License Limitations or Conditions for DOH Webpage: | |
| | Board Order: |
|
