Organization Active NPI

Omnicare Plus, PC

  • Specialist
  • Rosedale, NY
National Provider Identifier
1205067436
Registry record updated Aug 5, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
177953 Issued in NY
Legal business name
OMNICARE PLUS, PC
Practice address
23428 Merrick Blvd
2ND FL
Rosedale, NY 11422-1320
Phone
(718) 636-3990
Fax
(718) 636-5140
NPI assigned
Aug 5, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2009

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

Authorized official

Name
Evans Crevecoeur, M.D.
Title
Anesthesiologist
Phone
(718) 622-0111

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 177953 NY Primary

Addresses

Primary practice location

23428 Merrick Blvd
2ND FL
Rosedale, NY 11422-1320

Mailing address

55 Greene Ave
Suite Lla
Brooklyn, NY 11238-1026
Phone (718) 622-0111

National Provider Directory

National Provider Directory

Locations

23428 Merrick Blvd
Fl 2
Rosedale, NY 11422
Phone (718) 636-3990

Ownership & related parties

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1249430400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1249430400000",
    "number": "1205067436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 GREENE AVE",
            "address_2": "SUITE LLA",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112381026",
            "telephone_number": "718-622-0111",
            "fax_number": "718-636-5140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23428 MERRICK BLVD",
            "address_2": "2ND FL",
            "city": "ROSEDALE",
            "state": "NY",
            "postal_code": "114221320",
            "telephone_number": "718-636-3990",
            "fax_number": "718-636-5140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OMNICARE PLUS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-05",
        "last_updated": "2009-08-05",
        "status": "A",
        "authorized_official_last_name": "CREVECOEUR",
        "authorized_official_first_name": "EVANS",
        "authorized_official_title_or_position": "ANESTHESIOLOGIST",
        "authorized_official_telephone_number": "718-622-0111",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NY",
            "license": "177953",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rosedale, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 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.