Promeda Medical and Diagnostics, P.C.

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

2419811 Issued in NY

Legal business name

PROMEDA MEDICAL AND DIAGNOSTICS, P.C.

Practice address

2678 Gerritsen Ave
Brooklyn, NY 11229-5947

Phone

(718) 333-0275

NPI assigned

Dec 20, 2007

Last updated

Dec 20, 2007By 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. Abdalla Ishag Adam, M.D.

Title

Medical Director

Phone

(718) 333-0275

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1198108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198108800000",
    "number": "1407030828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2678 GERRITSEN AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112295947",
            "telephone_number": "718-333-0275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2678 GERRITSEN AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112295947",
            "telephone_number": "718-333-0275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROMEDA MEDICAL AND DIAGNOSTICS, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-20",
        "last_updated": "2007-12-20",
        "status": "A",
        "authorized_official_last_name": "ADAM",
        "authorized_official_first_name": "ABDALLA",
        "authorized_official_middle_name": "ISHAG",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "718-333-0275",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NY",
            "license": "2419811",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Medicine & Rehabilitation Physician in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Physical Medicine & Rehabilitation Physician in New York

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