NPIMap

Organization Active NPI

Wyckoff Professional Medical Services PC

  • Clinic/Center
  • Brooklyn, NY
National Provider Identifier
1205201837
Registry record updated Dec 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
WYCKOFF PROFESSIONAL MEDICAL SERVICES PC
Practice address
1419 Myrtle Ave
Wyckoff Doctors
Brooklyn, NY 11237-4512
Phone
(718) 783-0934
Fax
(718) 857-0162
NPI assigned
Dec 8, 2015
Organization subpart
Yes
Parent organization
WYCKOFF PROFESSIONAL MEDICAL SERVICES PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 15, 2025

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

Authorized official

Name
Vali Gache
Title
Ceo
Phone
(718) 240-1791

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

1419 Myrtle Ave
Wyckoff Doctors
Brooklyn, NY 11237-4512

Mailing address

374 Stockholm Street
Wyckoff Heights Medical Center - Faculty Practice
Brooklyn, NY 11237
Phone (718) 963-7272

Other identifiers 1

IdentifierTypeStateIssuer
03722025MedicaidNY

National Provider Directory

National Provider Directory
Tax ID family
Wyckoff Orthopaedic Ser4 organizations share this tax ID, including this one
Part of
Wyckoff Orthopaedic Ser

Other organizations with this tax ID 3

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

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1449532800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765756800000",
    "number": "1205201837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "374 STOCKHOLM STREET",
            "address_2": "WYCKOFF HEIGHTS MEDICAL CENTER - FACULTY PRACTICE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11237",
            "telephone_number": "718-963-7272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1419 MYRTLE AVE",
            "address_2": "WYCKOFF DOCTORS",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112374512",
            "telephone_number": "718-783-0934",
            "fax_number": "718-857-0162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WYCKOFF PROFESSIONAL MEDICAL SERVICES PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WYCKOFF PROFESSIONAL MEDICAL SERVICES PC",
        "enumeration_date": "2015-12-08",
        "last_updated": "2025-12-15",
        "certification_date": "2025-12-15",
        "status": "A",
        "authorized_official_last_name": "GACHE",
        "authorized_official_first_name": "VALI",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "718-240-1791"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03722025",
            "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 Dec 15, 2025; 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.