Evergreen Medical PLLC

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

Legal business name

EVERGREEN MEDICAL PLLC

Practice address

755-759 61St Street
Brooklyn, NY 11220-4211

Phone

(718) 680-8881

Fax

(718) 680-7880

NPI assigned

Mar 30, 2009

Organization subpart

No

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

Authorized official

Name

Miss May Lin

Title

Office Manager

Phone

(718) 680-8881

Specialties & licenses 4

Addresses

Other identifiers 4

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

{
    "created_epoch": "1238371200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1243987200000",
    "number": "1164664652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "755-759 61ST STREET",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112204211",
            "telephone_number": "718-680-8881",
            "fax_number": "718-680-7880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755-759 61ST STREET",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112204211",
            "telephone_number": "718-680-8881",
            "fax_number": "718-680-7880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN MEDICAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-30",
        "last_updated": "2009-06-03",
        "status": "A",
        "authorized_official_last_name": "LIN",
        "authorized_official_first_name": "MAY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "718-680-8881",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Rheumatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02440279",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03032428",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02681267",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03036766",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alexandra Everett, LCSW
• Evergreen Boro Park Comprehensive Medicine PLLC
• Evergreen DME, Inc.
• Evergreen Family Medical Services,P.C.
• Evergreen Gables Physical Therapy PC
• Evergreen Pharmacy Inc
• Evergreen Senior Daycare Center
• Evergreen Senior Daycare Center Inc
• Evergreen Surgical Supply Inc.
• Wendy Evers-Velazquez, LCSW

• Neurology Physician in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Neurology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 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.