Organization Active NPI

Amra Medical , P.C

  • Legal Medicine
  • Brooklyn, NY
National Provider Identifier
1497095822
Registry record updated Feb 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Legal MedicineTaxonomy code 173000000X
Legal business name
AMRA MEDICAL , P.C
Practice address
284 Avenue X
Brooklyn, NY 11223-5934
Phone
(718) 645-3405
Fax
(718) 645-3404
NPI assigned
Feb 21, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2013

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

Authorized official

Name
Dr. Sergey Petrov, MD
Title
Medical Doctor
Phone
(718) 645-3405

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Legal MedicineGroup: 193200000X MULTI-SPECIALTY GROUP 173000000X Primary

Addresses

Primary practice location

284 Avenue X
Brooklyn, NY 11223-5934

Mailing address

284 Avenue X
Brooklyn, NY 11223-5934
Phone (718) 645-3405

Other identifiers 1

IdentifierTypeStateIssuer
TF-3104283OtherNYNY STATE DEPARTMENT OF TAXATION AND FINANCE

National Provider Directory

National Provider Directory

Locations

284 Avenue X
Brooklyn, NY 11223
Phone (718) 645-3398

Practitioners & affiliated clinicians

Practitioners 4

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": "1361404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1361404800000",
    "number": "1497095822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "284 AVENUE X",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112235934",
            "telephone_number": "718-645-3405",
            "fax_number": "718-645-3404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "284 AVENUE X",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112235934",
            "telephone_number": "718-645-3405",
            "fax_number": "718-645-3404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMRA MEDICAL , P.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-21",
        "last_updated": "2013-02-21",
        "status": "A",
        "authorized_official_last_name": "PETROV",
        "authorized_official_first_name": "SERGEY",
        "authorized_official_title_or_position": "MEDICAL DOCTOR",
        "authorized_official_telephone_number": "718-645-3405",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "173000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Legal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NY STATE DEPARTMENT OF TAXATION AND FINANCE",
            "identifier": "TF-3104283",
            "state": "NY"
        }
    ],
    "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 Feb 21, 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.