NPIMap

Organization Active NPI

Route 22 Medical PC

  • Internal Medicine Physician
  • Brewster, NY
National Provider Identifier
1578643276
Registry record updated Aug 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
203453 Issued in NY
Legal business name
ROUTE 22 MEDICAL PC
Practice address
1591 Route 22
Brewster, NY 10509-4026
Phone
(845) 278-8797
Fax
(845) 278-8798
NPI assigned
Oct 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2008

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

Authorized official

Name
Luigia Gina Notaristefano, MDNPI 1093897118
Title
Practitioner
Phone
(845) 278-8797

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 203453 NY Primary

Addresses

Primary practice location

1591 Route 22
Brewster, NY 10509-4026

Mailing address

1591 Route 22
Brewster, NY 10509
Phone (845) 278-8797

Other identifiers 1

IdentifierTypeStateIssuer
02222755MedicaidNY

National Provider Directory

National Provider Directory

Locations

1591 Route 22
Brewster, NY 10509
Phone (845) 278-8797

Practitioners & affiliated clinicians

Practitioners 8

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": "1161043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219017600000",
    "number": "1578643276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1591 ROUTE 22",
            "city": "BREWSTER",
            "state": "NY",
            "postal_code": "10509",
            "telephone_number": "845-278-8797",
            "fax_number": "845-278-8798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1591 ROUTE 22",
            "city": "BREWSTER",
            "state": "NY",
            "postal_code": "105094026",
            "telephone_number": "845-278-8797",
            "fax_number": "845-278-8798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROUTE 22 MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-17",
        "last_updated": "2008-08-18",
        "status": "A",
        "authorized_official_last_name": "NOTARISTEFANO",
        "authorized_official_first_name": "LUIGIA",
        "authorized_official_middle_name": "GINA",
        "authorized_official_title_or_position": "PRACTITIONER",
        "authorized_official_telephone_number": "845-278-8797",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "203453",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02222755",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brewster, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 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.