Island Men's Medical Health Practice, PC

Primary specialty

Hematology (Internal Medicine) PhysicianTaxonomy code 207RH0000X

License

097198 Issued in NY

Legal business name

ISLAND MEN'S MEDICAL HEALTH PRACTICE, PC

Practice address

1551 Richmond Rd
Staten Island, NY 10304-2313

Phone

(718) 979-4350

Fax

(718) 979-4825

NPI assigned

Jan 10, 2013

Last updated

Jan 10, 2013By 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

Barry Gordon, MD

Title

Physician

Phone

(718) 979-4350

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1357776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1357776000000",
    "number": "1437496510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1551 RICHMOND RD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103042313",
            "telephone_number": "718-979-4350",
            "fax_number": "718-979-4825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1551 RICHMOND RD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103042313",
            "telephone_number": "718-979-4350",
            "fax_number": "718-979-4825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ISLAND MEN'S MEDICAL HEALTH PRACTICE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-10",
        "last_updated": "2013-01-10",
        "status": "A",
        "authorized_official_last_name": "GORDON",
        "authorized_official_first_name": "BARRY",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "718-979-4350",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RH0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology",
            "state": "NY",
            "license": "097198",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Hematology (Internal Medicine) Physician in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Hematology (Internal Medicine) Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2013; 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.