Organization Active NPI

Marina Perlova Medical PC

  • Internal Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1376551606
Registry record updated Mar 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
203540 Issued in NY
Legal business name
MARINA PERLOVA MEDICAL PC
Practice address
2327 83Rd St
Suite C
Brooklyn, NY 11214-2750
Phone
(718) 265-3003
Fax
(718) 265-1807
NPI assigned
Aug 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2008

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

Authorized official

Name
Mrs. Marina Perlova, MDNPI 1598985418
Title
President
Phone
(718) 265-3003

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 203540 NY Primary

Addresses

Primary practice location

2327 83Rd St
Suite C
Brooklyn, NY 11214-2750

Mailing address

183 72ND St
Brooklyn, NY 11209-1910
Phone (718) 265-3003

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041204000067 NY Part B Supplier - Clinic/Group Practice 9537125232 Receives reassigned benefits from 1 practitioner
Practice locations: Brooklyn, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1154563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206144000000",
    "number": "1376551606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "183 72ND ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112091910",
            "telephone_number": "718-265-3003",
            "fax_number": "718-265-1807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2327 83RD ST",
            "address_2": "SUITE C",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112142750",
            "telephone_number": "718-265-3003",
            "fax_number": "718-265-1807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARINA PERLOVA MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-03",
        "last_updated": "2008-03-22",
        "status": "A",
        "authorized_official_last_name": "PERLOVA",
        "authorized_official_first_name": "MARINA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-265-3003",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "203540",
            "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 Mar 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.