NPIMap

Organization Active NPI

Aysar Benyamen Fathalah-Mammo,Physician,PC

  • Primary Care Clinic/Center
  • Brooklyn, NY
National Provider Identifier
1427347350
Registry record updated Mar 31, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
212576 Issued in NY
Legal business name
AYSAR BENYAMEN FATHALAH-MAMMO,PHYSICIAN,PC
Practice address
8000 4TH Ave
Brooklyn, NY 11209-3959
Phone
(718) 748-2818
Fax
(718) 833-1016
NPI assigned
Mar 31, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2011

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

Authorized official

Name
Dr. Aysar B Fathallah-Mammo, MDNPI 1144230921
Title
President
Phone
(516) 801-0662

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
Primary Care Clinic/Center 261QP2300X 212576 NY Primary

Addresses

Primary practice location

8000 4TH Ave
Brooklyn, NY 11209-3959

Mailing address

372 Elm Dr
Roslyn, NY 11576-3013
Phone (516) 801-0662

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": "1301529600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1301529600000",
    "number": "1427347350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "372 ELM DR",
            "city": "ROSLYN",
            "state": "NY",
            "postal_code": "115763013",
            "telephone_number": "516-801-0662",
            "fax_number": "718-833-1016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8000 4TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112093959",
            "telephone_number": "718-748-2818",
            "fax_number": "718-833-1016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AYSAR BENYAMEN FATHALAH-MAMMO,PHYSICIAN,PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-31",
        "last_updated": "2011-03-31",
        "status": "A",
        "authorized_official_last_name": "FATHALLAH-MAMMO",
        "authorized_official_first_name": "AYSAR",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "516-801-0662",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NY",
            "license": "212576",
            "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 31, 2011; 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.