Organization Active NPI

Marvinbrombergpc

  • General Practice Dentistry
  • New York, NY
National Provider Identifier
1225178452
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
MARVINBROMBERGPC
Practice address
104 East 40 Street
Suite 502
New York, NY 10016
Phone
(212) 697-4171
Fax
(212) 867-7135
NPI assigned
Feb 7, 2007
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
Dr. Moe Vokshoor, DDS
Title
VP
Phone
(212) 697-4171

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

104 East 40 Street
Suite 502
New York, NY 10016

Mailing address

104 East 40TH Street
502
New York, NY 10016
Phone (212) 697-4171

National Provider Directory

National Provider Directory

Locations

104 E 40th St
#502
New York, NY 10016

104 E 40th St
Ste 502
New York, NY 10016
Phone (212) 687-3808

NPI Registry JSON

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1225178452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 EAST 40TH STREET",
            "address_2": "502",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10016",
            "telephone_number": "212-697-4171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 EAST 40 STREET",
            "address_2": "SUITE 502",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10016",
            "telephone_number": "212-697-4171",
            "fax_number": "212-867-7135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARVINBROMBERGPC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "VOKSHOOR",
        "authorized_official_first_name": "MOE",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "212-697-4171",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, 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.