Medical Polis P.C.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

233906 Issued in NY

Legal business name

MEDICAL POLIS P.C.

Practice address

2639 Atlantic Ave
Brooklyn, NY 11207-2407

Phone

(718) 385-1115

NPI assigned

Aug 29, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Nikolai Lagoduke, M.D.

Title

President

Phone

(848) 203-9608

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1188345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188345600000",
    "number": "1295929701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 747896",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113747896",
            "telephone_number": "848-203-9608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2639 ATLANTIC AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112072407",
            "telephone_number": "718-385-1115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL POLIS P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-29",
        "last_updated": "2007-08-29",
        "status": "A",
        "authorized_official_last_name": "LAGODUKE",
        "authorized_official_first_name": "NIKOLAI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "848-203-9608",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "233906",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2007; 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.