Park Slope Advanced Medical, PLLC

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

PARK SLOPE ADVANCED MEDICAL, PLLC

Practice address

348 13TH St Ste 201
Brooklyn, NY 11215-6179

Phone

(718) 840-0815

Fax

(718) 499-2704

NPI assigned

Dec 1, 2010

Last updated

Dec 1, 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

Rosemarie Phillip, M.D.

Title

Ceo

Phone

(718) 840-0815

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1291161600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291161600000",
    "number": "1104128834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "348 13TH ST STE 201",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112156179",
            "telephone_number": "718-840-0815",
            "fax_number": "718-499-2704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "348 13TH ST STE 201",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112156179",
            "telephone_number": "718-840-0815",
            "fax_number": "718-499-2704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK SLOPE ADVANCED MEDICAL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-01",
        "last_updated": "2010-12-01",
        "status": "A",
        "authorized_official_last_name": "PHILLIP",
        "authorized_official_first_name": "ROSEMARIE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "718-840-0815",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AAAASF, INC.",
            "identifier": "CERTIFICATION# 3934",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 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.