NPIMap

Organization Active NPI

Edison Medical PC

  • Internal Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1326311341
Registry record updated Feb 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
EDISON MEDICAL PC
Practice address
406 15TH St
M2
Brooklyn, NY 11215-6054
Phone
(718) 499-6590
Fax
(718) 499-6594
NPI assigned
Feb 22, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2012

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

Authorized official

Name
Azu Ajudua, MD
Title
Owner
Phone
(718) 499-6590

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

406 15TH St
M2
Brooklyn, NY 11215-6054

Mailing address

PO Box 2215
New York, NY 10101-2215
Phone (718) 499-6590

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

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

NPI Registry JSON

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

{
    "created_epoch": "1329868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329868800000",
    "number": "1326311341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2215",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101012215",
            "telephone_number": "718-499-6590",
            "fax_number": "718-499-6594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 15TH ST",
            "address_2": "M2",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112156054",
            "telephone_number": "718-499-6590",
            "fax_number": "718-499-6594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDISON MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-22",
        "last_updated": "2012-02-22",
        "status": "A",
        "authorized_official_last_name": "AJUDUA",
        "authorized_official_first_name": "AZU",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-499-6590",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal 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 Feb 22, 2012; 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.