NPIMap

Organization Active NPI

Utica Comprehensive Medical Office

  • Internal Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1336485572
Registry record updated Dec 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
130554 Issued in NY
Legal business name
UTICA COMPREHENSIVE MEDICAL OFFICE
Practice address
535 Utica Ave
Brooklyn, NY 11203-1974
Phone
(718) 221-2400
Fax
(718) 221-2407
NPI assigned
Dec 17, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2012

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

Authorized official

Name
Dr. Azu A Ajudua, M.D.
Title
Owner
Phone
(718) 221-2400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207R00000X 130554 NY Primary

Addresses

Primary practice location

535 Utica Ave
Brooklyn, NY 11203-1974

Mailing address

535 Utica Ave
Brooklyn, NY 11203-1974
Phone (718) 221-2400

National Provider Directory

National Provider Directory

Locations

535 Utica Ave
Brooklyn, NY 11203
Phone (718) 221-2400

NPI Registry JSON

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

{
    "created_epoch": "1355702400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355702400000",
    "number": "1336485572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "535 UTICA AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112031974",
            "telephone_number": "718-221-2400",
            "fax_number": "718-221-2407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 UTICA AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112031974",
            "telephone_number": "718-221-2400",
            "fax_number": "718-221-2407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UTICA COMPREHENSIVE MEDICAL OFFICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-17",
        "last_updated": "2012-12-17",
        "status": "A",
        "authorized_official_last_name": "AJUDUA",
        "authorized_official_first_name": "AZU",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-221-2400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "130554",
            "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 Dec 17, 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.