Brooklyn Anti Aging Center Inc.

Primary specialty

Addiction Medicine (Psychiatry & Neurology) PhysicianTaxonomy code 2084A0401X

Legal business name

BROOKLYN ANTI AGING CENTER INC.

Practice address

745 64TH St
Brooklyn, NY 11220-4753

Phone

(718) 517-0665

NPI assigned

Nov 19, 2010

Organization subpart

No

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

Authorized official

Name

Sorang Kim

Title

President

Phone

(718) 517-0665

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1290124800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1290124800000",
    "number": "1477855757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "745 64TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112204753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "745 64TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112204753",
            "telephone_number": "718-517-0665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROOKLYN ANTI AGING CENTER INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-19",
        "last_updated": "2010-11-19",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "SORANG",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-517-0665"
    },
    "taxonomies": [
        {
            "code": "2084A0401X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Addiction Medicine (Psychiatry & Neurology) Physician in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Addiction Medicine (Psychiatry & Neurology) Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 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.