NPIMap

Organization Active NPI

Alla Brouk, M.D.,P.C.

  • Internal Medicine Physician
  • Englewood, NJ
National Provider Identifier
1548313398
Registry record updated Mar 13, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MA07770600 Issued in NJ
Legal business name
ALLA BROUK, M.D.,P.C.
Practice address
140 Grand Ave
Englewood, NJ 07631
Phone
(201) 569-9010
Fax
(201) 569-9063
NPI assigned
Jan 18, 2007
Last updated
Mar 13, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2009

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

Authorized official

Name
Alla Brouk, MDNPI 1396933149
Title
President
Phone
(201) 569-9010

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 25MA07770600 NJ Primary

Addresses

Primary practice location

140 Grand Ave
Englewood, NJ 07631

Mailing address

140 Grand Ave
Englewood, NJ 07631
Phone (201) 569-9010

Other identifiers 1

IdentifierTypeStateIssuer
0044652MedicaidNJ

Other names 1

  • Alla Brouk, M.D. Former legal business name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1236902400000",
    "number": "1548313398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 GRAND AVE",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "07631",
            "telephone_number": "201-569-9010",
            "fax_number": "201-569-9063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 GRAND AVE",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "07631",
            "telephone_number": "201-569-9010",
            "fax_number": "201-569-9063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLA BROUK, M.D.,P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-18",
        "last_updated": "2009-03-13",
        "status": "A",
        "authorized_official_last_name": "BROUK",
        "authorized_official_first_name": "ALLA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "201-569-9010",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA07770600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0044652",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Alla Brouk, M.D.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Englewood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2009; 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.