NPIMap

Organization Active NPI

Long Island College Hospital

Doing business as Medicine Specialty Group at Lich

  • Gastroenterology Physician
  • Brooklyn, NY
National Provider Identifier
1003863820
Registry record updated Nov 3, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
LONG ISLAND COLLEGE HOSPITAL
Doing business as
Medicine Specialty Group at Lich
Practice address
97 Amity St
Brooklyn, NY 11201-6004
Phone
(718) 780-2155
NPI assigned
May 27, 2006
Last updated
Nov 3, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Vladimir Privman, MDNPI 1659333193
Title
Managing Employee
Phone
(718) 780-2155

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RE0101X
Gastroenterology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RG0100X Primary

Addresses

Primary practice location

97 Amity St
Brooklyn, NY 11201-6004

Mailing address

160 Water St
20FL
New York, NY 10038-4922
Phone (212) 256-3682

Other identifiers 1

IdentifierTypeStateIssuer
02420102MedicaidNY

Other names 1

  • MEDICINE SPECIALTY GROUP AT LICH Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 18

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 18

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1257206400000",
    "number": "1003863820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 WATER ST",
            "address_2": "20FL",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100384922",
            "telephone_number": "212-256-3682",
            "fax_number": "212-256-3538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "97 AMITY ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112016004",
            "telephone_number": "718-780-2155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONG ISLAND COLLEGE HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-27",
        "last_updated": "2009-11-03",
        "status": "A",
        "authorized_official_last_name": "PRIVMAN",
        "authorized_official_first_name": "VLADIMIR",
        "authorized_official_title_or_position": "MANAGING EMPLOYEE",
        "authorized_official_telephone_number": "718-780-2155",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02420102",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MEDICINE SPECIALTY GROUP AT LICH",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.