Organization Active NPI

Five Boroughs Medical Associates, P.C.

  • Specialist
  • Riverhead, NY
National Provider Identifier
1548574155
Registry record updated Aug 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
255627 Issued in NY
Legal business name
FIVE BOROUGHS MEDICAL ASSOCIATES, P.C.
Practice address
36 Osprey Avenue
Riverhead, NY 11901
Phone
(347) 417-9081
NPI assigned
Aug 6, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2010

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

Authorized official

Name
Brian Marmor
Title
Administrator
Phone
(718) 629-5590

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 255627 NY Primary

Addresses

Primary practice location

36 Osprey Avenue
Riverhead, NY 11901

Mailing address

PO Box 158
Plainview, NY 11803
Phone (347) 417-9081

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1281052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1281052800000",
    "number": "1548574155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 158",
            "city": "PLAINVIEW",
            "state": "NY",
            "postal_code": "11803",
            "telephone_number": "347-417-9081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 OSPREY AVENUE",
            "city": "RIVERHEAD",
            "state": "NY",
            "postal_code": "11901",
            "telephone_number": "347-417-9081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIVE BOROUGHS MEDICAL ASSOCIATES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-06",
        "last_updated": "2010-08-06",
        "status": "A",
        "authorized_official_last_name": "MARMOR",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "718-629-5590"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NY",
            "license": "255627",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverhead, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2010; 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.