1501 Medical PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

1501 MEDICAL PC

Practice address

1501 80TH St Ste 1
Brooklyn, NY 11228-2533

Phone

(718) 837-2660

NPI assigned

Sep 2, 2010

Last updated

Sep 2, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ilya Pavlov Akselrud, MD

Title

Owner

Phone

(718) 837-2660

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1283385600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1283385600000",
    "number": "1083921779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 80TH ST STE 1",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112282533",
            "telephone_number": "718-837-2660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 80TH ST STE 1",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112282533",
            "telephone_number": "718-837-2660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "1501 MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-02",
        "last_updated": "2010-09-02",
        "status": "A",
        "authorized_official_last_name": "AKSELRUD",
        "authorized_official_first_name": "ILYA",
        "authorized_official_middle_name": "PAVLOV",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-837-2660",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2010; 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.