Northeast Family Medical PLLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

NORTHEAST FAMILY MEDICAL PLLC

Practice address

667 61St St
Brooklyn, NY 11220-4123

Phone

(516) 554-6477

Fax

(347) 889-5909

NPI assigned

Sep 8, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Frank Suppa, DO

Title

Owner

Phone

(516) 554-6477

Specialties & licenses 1

Addresses

Locations

Practitioners 3

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

• Steven Kong

  • Physician Assistant
  • Brooklyn, NY
  • NPI 1407142052
  NPD
• Yili Huang, D.O

  • Interventional Cardiology Physician
  • Elmhurst, NY
  • NPI 1093967184
  NPD (past)
• Eddie Wu, DNP, APRN, FNP-BC

  • Family Nurse Practitioner
  • Brooklyn, NY
  • NPI 1851248140
  NPD (past)

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

{
    "created_epoch": "1662595200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1285355248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "138 MAIN ST # 1009",
            "city": "EAST ROCKAWAY",
            "state": "NY",
            "postal_code": "115181702",
            "telephone_number": "516-554-6477",
            "fax_number": "347-889-5915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "667 61ST ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112204123",
            "telephone_number": "516-554-6477",
            "fax_number": "347-889-5909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST FAMILY MEDICAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-08",
        "last_updated": "2023-03-07",
        "certification_date": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "SUPPA",
        "authorized_official_first_name": "FRANK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "516-554-6477",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "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 Mar 7, 2023; 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.