Brentwood Medical Care, PC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

183817 Issued in NY

Legal business name

BRENTWOOD MEDICAL CARE, PC

Practice address

55 Second Ave
Suite 1
Brentwood, NY 11717-4611

Phone

(631) 751-5588

NPI assigned

Dec 27, 2006

Last updated

Oct 29, 2010By 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. Matthew J Viso, DC

Title

Manager

Phone

(631) 751-5588

Specialties & licenses 1

Addresses

Tax ID family

Brentwood Medical Care PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Brentwood Medical Care, PC

  • Internal Medicine Physician
  • East Northport, NY
  • NPI 1699830745
  NPD tax ID

Locations

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288310400000",
    "number": "1417012568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1890 NEW YORK AVE",
            "city": "HUNTINGTON STATION",
            "state": "NY",
            "postal_code": "117462904",
            "telephone_number": "631-427-6920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 SECOND AVE",
            "address_2": "SUITE 1",
            "city": "BRENTWOOD",
            "state": "NY",
            "postal_code": "117174611",
            "telephone_number": "631-751-5588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRENTWOOD MEDICAL CARE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-27",
        "last_updated": "2010-10-29",
        "status": "A",
        "authorized_official_last_name": "VISO",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "631-751-5588",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NY",
            "license": "183817",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Physician in Brentwood, NY
• Providers in Brentwood, NY by specialty
• General Practice Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2010; 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.