Park Slope Medical PLLC

Primary specialty

SpecialistTaxonomy code 174400000X

License

CERT # 5239 Issued in NY

Legal business name

PARK SLOPE MEDICAL PLLC

Practice address

405 5TH Ave
Brooklyn, NY 11215-3315

Phone

(718) 768-7246

Fax

(718) 768-7303

NPI assigned

May 23, 2014

Organization subpart

No

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

Authorized official

Name

Abdulquader Khan, MDNPI 1013146216

Title

President

Phone

(718) 768-7246

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Abdulquader Khan, M.D.

  • Pain Medicine Physician
  • Brooklyn, NY
  • NPI 1013146216
  NPD Authorized official

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

{
    "created_epoch": "1400803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1400803200000",
    "number": "1285046375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 RUGBY RD",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112302410",
            "telephone_number": "718-768-7246",
            "fax_number": "718-768-7303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 5TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112153315",
            "telephone_number": "718-768-7246",
            "fax_number": "718-768-7303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK SLOPE MEDICAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-23",
        "last_updated": "2014-05-23",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "ABDULQUADER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-768-7246",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "NY",
            "license": "CERT # 5239",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AAAASF, INC.",
            "identifier": "5239",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Park Slope Kids Dental Care
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• Park Slope Medical Office PC
• Park Slope Medical Service PC
• Park Slope Medicine, P.C.
• Park Slope Medicine, P.C.
• Park Slope Medicine, P.C.
• Park Slope Medicine, PC

• Specialist in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2014; 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.