NPIMap

Organization Active NPI

Central Brooklyn Medical Group

  • Obstetrics Physician
  • Brooklyn, NY
National Provider Identifier
1184712341
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics PhysicianTaxonomy code 207VX0000X
License
239572 Issued in NY
Legal business name
CENTRAL BROOKLYN MEDICAL GROUP
Practice address
345 Schermerhorn St
Brooklyn, NY 11217-1025
Phone
(718) 403-3519
NPI assigned
Oct 11, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Lucille Mazza
Title
Asst Coo
Phone
(718) 403-3519

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207VX0000X 239572 NY Primary

Addresses

Primary practice location

345 Schermerhorn St
Brooklyn, NY 11217-1025

Mailing address

345 Schermerhorn St
Brooklyn, NY 11217-1025
Phone (718) 403-3519

Other identifiers 1

IdentifierTypeStateIssuer
239572OtherNYLIC

National Provider Directory

National Provider Directory
Tax ID family
Central Brooklyn Medical Group6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

345 Schermerhorn St
Brooklyn, NY 11217
Phone (718) 403-3547

NPI Registry JSON

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1184712341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345 SCHERMERHORN ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112171025",
            "telephone_number": "718-403-3519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 SCHERMERHORN ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112171025",
            "telephone_number": "718-403-3519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL BROOKLYN MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MAZZA",
        "authorized_official_first_name": "LUCILLE",
        "authorized_official_title_or_position": "ASST COO",
        "authorized_official_telephone_number": "718-403-3519",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207VX0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": "NY",
            "license": "239572",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LIC",
            "identifier": "239572",
            "state": "NY"
        }
    ],
    "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 Aug 22, 2020; 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.