NPIMap

Organization Active NPI

Jennifer Grodberg MD, PLLC

  • Internal Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1477858405
Registry record updated Jan 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
219831 Issued in NY
Legal business name
JENNIFER GRODBERG MD, PLLC
Practice address
68 Jay St
Suite 507
Brooklyn, NY 11201-1186
Phone
(718) 360-5379
NPI assigned
Jan 23, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2011

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

Authorized official

Name
Dr. Jennifer Beth Grodberg, M.D.
Title
Owner
Phone
(718) 360-5379

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 219831 NY Primary

Addresses

Primary practice location

68 Jay St
Suite 507
Brooklyn, NY 11201-1186

Mailing address

68 Jay St
Suite 507
Brooklyn, NY 11201-1186
Phone (718) 360-5379

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1295740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1295740800000",
    "number": "1477858405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "68 JAY ST",
            "address_2": "SUITE 507",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112011186",
            "telephone_number": "718-360-5379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "68 JAY ST",
            "address_2": "SUITE 507",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112011186",
            "telephone_number": "718-360-5379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JENNIFER GRODBERG MD, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-23",
        "last_updated": "2011-01-23",
        "status": "A",
        "authorized_official_last_name": "GRODBERG",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "BETH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-360-5379",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "219831",
            "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 Jan 23, 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.