Three Rivers Medical of New York PLLC

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

Legal business name

THREE RIVERS MEDICAL OF NEW YORK PLLC

Practice address

2601 Ocean Pkwy
Brooklyn, NY 11235-7745

Phone

(917) 540-0837

NPI assigned

Jun 22, 2024

Organization subpart

No

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

Authorized official

Name

Michael M Wasser

Title

Manager

Phone

(805) 608-3600

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1719014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719014400000",
    "number": "1164266334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1511 3RD AVE STE 1000",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981013637",
            "telephone_number": "805-608-3600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 OCEAN PKWY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112357745",
            "telephone_number": "917-540-0837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THREE RIVERS MEDICAL OF NEW YORK PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-22",
        "last_updated": "2024-06-22",
        "certification_date": "2024-06-22",
        "status": "A",
        "authorized_official_last_name": "WASSER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "805-608-3600"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Neurology Physician in Brooklyn, NY
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• Neurology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2024; 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.