Brooklyn Medical Services of Ny

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

BROOKLYN MEDICAL SERVICES OF NY

Practice address

1575 E 19TH St
Brooklyn, NY 11230-7203

Phone

(718) 339-7500

Fax

(718) 228-6485

NPI assigned

Sep 24, 2019

Last updated

Sep 24, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Wendell Joseph Gorum II, M.D.

Title

Owner/Medical Director

Phone

(718) 339-7500

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1569283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1569283200000",
    "number": "1326699117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1575 E 19TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112307203",
            "telephone_number": "718-339-7500",
            "fax_number": "718-228-6485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1575 E 19TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112307203",
            "telephone_number": "718-339-7500",
            "fax_number": "718-228-6485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROOKLYN MEDICAL SERVICES OF NY",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-24",
        "last_updated": "2019-09-24",
        "status": "A",
        "authorized_official_last_name": "GORUM",
        "authorized_official_first_name": "WENDELL",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "OWNER/MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "718-339-7500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AAAASF",
            "identifier": "6659",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brooklyn Medical Infusions PC
• Brooklyn Medical of New York LLC
• Brooklyn Medical Office PLLC
• Brooklyn Medical P.L.L.C
• Brooklyn Medical Practice PC
• Brooklyn Medical Systems Ipa 2
• Brooklyn Mint Dental, PLLC
• Brooklyn Motion Chiropractic PC
• Brooklyn Nephrology Group, P.C.
• Brooklyn Neurological Associates PC

• Multi-Specialty Clinic/Center in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Multi-Specialty Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2019; 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.