Joel Brock, M.D

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

119043 Issued in NY

Practice address

479 Sleight Ave
Staten Island, NY 10307-1942

Phone

(718) 605-5225

Fax

(718) 605-5225

NPI assigned

Sep 23, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• University Physicians Group P C

  • General Practice Physician
  • Staten Island, NY
  • NPI 1104872134

  General Practice

  NPD (past)

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

{
    "created_epoch": "1253664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1253664000000",
    "number": "1104150283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "479 SLEIGHT AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103071942",
            "telephone_number": "718-605-5225",
            "fax_number": "718-605-5225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "479 SLEIGHT AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103071942",
            "telephone_number": "718-605-5225",
            "fax_number": "718-605-5225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROCK",
        "first_name": "JOEL",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-09-23",
        "last_updated": "2009-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NY",
            "license": "119043",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Svetlana Briskman, CCC-SLP
• Kaitlin Bristol, OTR/L
• Broad Street Pharma Corp
• Broadway Physical Therapy LLC
• Catrine Brobbey
• Hannah Otelia Brockman
• Alina Brodskaya, NP
• Joseph Anthony Brogna, D.C.
• Vincent J Broillet, MD
• Dmitri Broitman, B.S. PHARM.

• All providers in Staten Island, NY
• General Practice Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 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.