NPIMap

Organization Active NPI

Park Slope Physician Services PC

  • Internal Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1013018324
Registry record updated Aug 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
PARK SLOPE PHYSICIAN SERVICES PC
Practice address
1309 Avenue J
Brooklyn, NY 11230-3605
Phone
(718) 677-1710
Fax
(718) 677-6586
NPI assigned
Sep 26, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2008

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

Authorized official

Name
Mr. Joel Gordon
Title
Executive Director
Phone
(718) 780-3031

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

1309 Avenue J
Brooklyn, NY 11230-3605

Mailing address

PO Box 5451
New York, NY 10087-5451
Phone (717) 625-3999

Other identifiers 1

IdentifierTypeStateIssuer
01916229MedicaidNY

National Provider Directory

National Provider Directory

Locations

9438 58th Ave
#G3
Flushing, NY 11373
Phone (718) 393-3900

Practitioners & affiliated clinicians

Practitioners 67

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 67

NPI Registry JSON

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219708800000",
    "number": "1013018324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5451",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100875451",
            "telephone_number": "717-625-3999",
            "fax_number": "717-625-3986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1309 AVENUE J",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112303605",
            "telephone_number": "718-677-1710",
            "fax_number": "718-677-6586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK SLOPE PHYSICIAN SERVICES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-26",
        "last_updated": "2008-08-26",
        "status": "A",
        "authorized_official_last_name": "GORDON",
        "authorized_official_first_name": "JOEL",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "718-780-3031",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01916229",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Aug 26, 2008; 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.