Life Line Medical Care, PC

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

215021 Issued in NY

Legal business name

LIFE LINE MEDICAL CARE, PC

Practice address

3048 Brighton 1St St
Ground Floor
Brooklyn, NY 11235-8009

Phone

(917) 703-1725

NPI assigned

Mar 22, 2013

Last updated

Mar 22, 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

Ludmila Dashevsky, DO

Title

Owner

Phone

(917) 703-1725

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1363910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1363910400000",
    "number": "1518209063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 W BROADWAY",
            "city": "LONG BEACH",
            "state": "NY",
            "postal_code": "115614047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3048 BRIGHTON 1ST ST",
            "address_2": "GROUND FLOOR",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112358009",
            "telephone_number": "917-703-1725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE LINE MEDICAL CARE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-22",
        "last_updated": "2013-03-22",
        "status": "A",
        "authorized_official_last_name": "DASHEVSKY",
        "authorized_official_first_name": "LUDMILA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "917-703-1725",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NY",
            "license": "215021",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Behavior Analyst in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Behavior Analyst in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 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.