Westside Community Physician P.C.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

60087148 Issued in NY

Legal business name

WESTSIDE COMMUNITY PHYSICIAN P.C.

Practice address

30 W 60TH St Apt 1D
New York, NY 10023-7906

Phone

(212) 581-3553

Fax

(212) 246-1608

NPI assigned

Jun 13, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Kamin Soogrim

Title

Office Manager

Phone

(212) 477-3544

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1181692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1558565622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 W 60TH ST APT 1D",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100237906",
            "telephone_number": "212-581-3553",
            "fax_number": "212-246-1608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 W 60TH ST APT 1D",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100237906",
            "telephone_number": "212-581-3553",
            "fax_number": "212-246-1608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTSIDE COMMUNITY PHYSICIAN P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SOOGRIM",
        "authorized_official_first_name": "KAMIN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "212-477-3544",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "60087148",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "C07370",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in New York, NY
• Providers in New York, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.