Organization Active NPI

Back to Health Medical PC

  • Physical Medicine & Rehabilitation Physician
  • Brooklyn, NY
National Provider Identifier
1306121330
Registry record updated Oct 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
214360 Issued in NY
Legal business name
BACK TO HEALTH MEDICAL PC
Practice address
1729 E 12TH St
FL 4
Brooklyn, NY 11229-1088
Phone
(718) 998-3020
Fax
(718) 998-9059
NPI assigned
Oct 21, 2011
Last updated
Oct 21, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2011

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

Authorized official

Name
Dorina Drukman, MDNPI 1659346088
Title
Director
Phone
(212) 867-0405

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
Physical Medicine & Rehabilitation Physician 208100000X 214360 NY Primary

Addresses

Primary practice location

1729 E 12TH St
FL 4
Brooklyn, NY 11229-1088

Mailing address

1729 E 12TH St
FL 4
Brooklyn, NY 11229-1088
Phone (718) 998-3020

Other identifiers 1

IdentifierTypeStateIssuer
03360405MedicaidNY

National Provider Directory

National Provider Directory

Locations

1729 E 12th St
Fl 4
Brooklyn, NY 11229
Phone (718) 410-1500

Practitioners & affiliated clinicians

Practitioners 1

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": "1319155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1319155200000",
    "number": "1306121330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1729 E 12TH ST",
            "address_2": "FL 4",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112291088",
            "telephone_number": "718-998-3020",
            "fax_number": "718-998-9059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1729 E 12TH ST",
            "address_2": "FL 4",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112291088",
            "telephone_number": "718-998-3020",
            "fax_number": "718-998-9059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BACK TO HEALTH MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-21",
        "last_updated": "2011-10-21",
        "status": "A",
        "authorized_official_last_name": "DRUKMAN",
        "authorized_official_first_name": "DORINA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "212-867-0405",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NY",
            "license": "214360",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03360405",
            "state": "NY"
        }
    ],
    "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 Oct 21, 2011; 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.