NPIMap

Organization Active NPI

Eddy J. Vincent Physician,P.C.

  • Specialist
  • Brooklyn, NY
National Provider Identifier
1366989790
Registry record updated Jan 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
133188 Issued in NY
Legal business name
EDDY J. VINCENT PHYSICIAN,P.C.
Practice address
1164 Nostrand Ave
Brooklyn, NY 11225-5418
Phone
(718) 493-6964
NPI assigned
Jan 24, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2017

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

Authorized official

Name
Eddy J Vincent, M.D.
Title
Owner
Phone
(718) 493-6964

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 174400000X 133188 NY Primary

Addresses

Primary practice location

1164 Nostrand Ave
Brooklyn, NY 11225-5418

Mailing address

1164 Nostrand Ave
Brooklyn, NY 11225-5418
Phone (718) 493-6964

National Provider Directory

National Provider Directory

Locations

1164 Nostrand Ave
Brooklyn, NY 11225
Phone (718) 363-1350

Practitioners & affiliated clinicians

Practitioners 7

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": "1485216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485216000000",
    "number": "1366989790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1164 NOSTRAND AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112255418",
            "telephone_number": "718-493-6964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1164 NOSTRAND AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112255418",
            "telephone_number": "718-493-6964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDDY J. VINCENT PHYSICIAN,P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-24",
        "last_updated": "2017-01-24",
        "status": "A",
        "authorized_official_last_name": "VINCENT",
        "authorized_official_first_name": "EDDY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-493-6964",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "NY",
            "license": "133188",
            "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 Jan 24, 2017; 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.