Diversified Diagnostic Services Medical Care PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

166959 Issued in NY

Legal business name

DIVERSIFIED DIAGNOSTIC SERVICES MEDICAL CARE PC

Practice address

3849 Nostrand Ave
Brooklyn, NY 11235-2012

Phone

(718) 368-9555

NPI assigned

Jul 9, 2008

Organization subpart

No

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

Authorized official

Name

Pavel Yutsis, M.D.

Title

President

Phone

(718) 368-9555

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1215561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215561600000",
    "number": "1225291362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3849 NOSTRAND AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112352012",
            "telephone_number": "718-368-9555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3849 NOSTRAND AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112352012",
            "telephone_number": "718-368-9555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVERSIFIED DIAGNOSTIC SERVICES MEDICAL CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-09",
        "last_updated": "2008-07-09",
        "status": "A",
        "authorized_official_last_name": "YUTSIS",
        "authorized_official_first_name": "PAVEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-368-9555",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "166959",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2008; 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.