Organization Active NPI

Ocean Avenue Medical, PC

  • Internal Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1114940574
Registry record updated Jul 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
167701 Issued in NY
Legal business name
OCEAN AVENUE MEDICAL, PC
Practice address
2700 Ocean Ave
Brooklyn, NY 11229-4604
Phone
(718) 934-6777
Fax
(718) 934-9560
NPI assigned
Jul 26, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2007

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

Authorized official

Name
Lazar Kaganovsky, MD
Title
President
Phone
(718) 934-6777

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X 167701 NY Primary

Addresses

Primary practice location

2700 Ocean Ave
Brooklyn, NY 11229-4604

Mailing address

2700 Ocean Ave
Brooklyn, NY 11229-4604
Phone (718) 934-6777

National Provider Directory

National Provider Directory

Locations

2700 Ocean Ave
Brooklyn, NY 11229
Phone (718) 336-3900

NPI Registry JSON

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184112000000",
    "number": "1114940574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 OCEAN AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112294604",
            "telephone_number": "718-934-6777",
            "fax_number": "718-934-9560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 OCEAN AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112294604",
            "telephone_number": "718-934-6777",
            "fax_number": "718-934-9560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OCEAN AVENUE MEDICAL, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-26",
        "last_updated": "2007-07-11",
        "status": "A",
        "authorized_official_last_name": "KAGANOVSKY",
        "authorized_official_first_name": "LAZAR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-934-6777",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "167701",
            "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 Jul 11, 2007; 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.