Organization Active NPI

Grigory Shtender Physician,PC

  • Specialist
  • Brooklyn, NY
National Provider Identifier
1396817094
Registry record updated Sep 20, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
218261 Issued in NY
Legal business name
GRIGORY SHTENDER PHYSICIAN,PC
Practice address
3001 Brighton 1St St
Brooklyn, NY 11235-8008
Phone
(718) 368-0100
Fax
(718) 368-1208
NPI assigned
Nov 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2007

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

Authorized official

Name
Grigory Shtender, MD
Title
President
Phone
(718) 368-0100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 218261 NY Primary

Addresses

Primary practice location

3001 Brighton 1St St
Brooklyn, NY 11235-8008

Mailing address

139 Quentin Rd
Brooklyn, NY 11223-1201
Phone (718) 368-0100

National Provider Directory

National Provider Directory

Locations

139 Quentin Rd
Brooklyn, NY 11223

NPI Registry JSON

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190246400000",
    "number": "1396817094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "139 QUENTIN RD",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112231201",
            "telephone_number": "718-368-0100",
            "fax_number": "718-368-1208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 BRIGHTON 1ST ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112358008",
            "telephone_number": "718-368-0100",
            "fax_number": "718-368-1208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRIGORY SHTENDER PHYSICIAN,PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-15",
        "last_updated": "2007-09-20",
        "status": "A",
        "authorized_official_last_name": "SHTENDER",
        "authorized_official_first_name": "GRIGORY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-368-0100",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NY",
            "license": "218261",
            "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 Sep 20, 2007; 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.