Organization Active NPI

Northeast Family Medical PLLC

  • Family Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1285355248
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
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
Last updated
Mar 7, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Authorized official

Name
Dr. Frank Suppa, DONPI 1700199213
Title
Owner
Phone
(516) 554-6477

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

667 61St St
Brooklyn, NY 11220-4123

Mailing address

138 Main St # 1009
East Rockaway, NY 11518-1702
Phone (516) 554-6477

National Provider Directory

National Provider Directory

Locations

1881 86th St
Brooklyn, NY 11214
Phone (347) 889-5918

1914 86th St
Brooklyn, NY 11214
Phone (347) 889-5918

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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": []
}

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 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.