NPIMap

Organization Active NPI

Gregory Suprin MD PLLC

  • Family Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1043428097
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
230165 Issued in NY
Legal business name
GREGORY SUPRIN MD PLLC
Practice address
1381 Linden Blvd # B
Brooklyn, NY 11212-4755
Phone
(718) 498-3103
Fax
(718) 498-3166
NPI assigned
May 21, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Gregory Suprin, M.DNPI 1447207071
Title
President Medical Director
Phone
(718) 498-3103

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 230165 NY Primary

Addresses

Primary practice location

1381 Linden Blvd # B
Brooklyn, NY 11212-4755

Mailing address

1381 Linden Blvd # B
Brooklyn, NY 11212-4755
Phone (718) 498-3103

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1043428097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1381 LINDEN BLVD # B",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112124755",
            "telephone_number": "718-498-3103",
            "fax_number": "718-498-3166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1381 LINDEN BLVD # B",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112124755",
            "telephone_number": "718-498-3103",
            "fax_number": "718-498-3166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREGORY SUPRIN MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SUPRIN",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_title_or_position": "PRESIDENT MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "718-498-3103",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "230165",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 22, 2020; 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.