NPIMap

Organization Active NPI

Methodist Outrach Lab

  • Clinical & Laboratory Dermatological Immunology Physician
  • Brooklyn, NY
National Provider Identifier
1205912813
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical & Laboratory Dermatological Immunology PhysicianTaxonomy code 207NI0002X
Legal business name
METHODIST OUTRACH LAB
Practice address
506 6TH St
Brooklyn, NY 11215-3609
Phone
(718) 780-3016
NPI assigned
Oct 27, 2006
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
Rabia Mir, MD
Title
Director
Phone
(718) 780-3016

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical & Laboratory Dermatological Immunology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207NI0002X Primary

Addresses

Primary practice location

506 6TH St
Brooklyn, NY 11215-3609

Mailing address

1900 Hempstead Tpke
Suite 500
East Meadow, NY 11554-1724
Phone (516) 542-1090

National Provider Directory

National Provider Directory
Tax ID family
Joseph P Stebbins9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

NPI Registry JSON

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1205912813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 HEMPSTEAD TPKE",
            "address_2": "SUITE 500",
            "city": "EAST MEADOW",
            "state": "NY",
            "postal_code": "115541724",
            "telephone_number": "516-542-1090",
            "fax_number": "516-794-8165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 6TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112153609",
            "telephone_number": "718-780-3016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METHODIST OUTRACH LAB",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MIR",
        "authorized_official_first_name": "RABIA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "718-780-3016",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207NI0002X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology, Clinical & Laboratory Dermatological Immunology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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.