Dr. Merab Boter Medical, P.C.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

173014 Issued in NY

Legal business name

DR. MERAB BOTER MEDICAL, P.C.

Practice address

2177 65TH St
2ND Floor
Brooklyn, NY 11204

Phone

(718) 238-1555

Fax

(718) 748-3666

NPI assigned

Apr 17, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Merab Boter, M.D.

Title

President

Phone

(718) 238-1555

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1220400000000",
    "number": "1538385604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2177 65TH ST",
            "address_2": "2ND FLOOR",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11204",
            "telephone_number": "718-238-1555",
            "fax_number": "718-748-3666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2177 65TH ST",
            "address_2": "2ND FLOOR",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11204",
            "telephone_number": "718-238-1555",
            "fax_number": "718-748-3666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. MERAB BOTER MEDICAL, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-17",
        "last_updated": "2008-09-03",
        "status": "A",
        "authorized_official_last_name": "BOTER",
        "authorized_official_first_name": "MERAB",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-238-1555",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "NY",
            "license": "173014",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01069218",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Surgery Physician in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Surgery Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2008; 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.