Active NPI
Marina Gurevich
- Specialist
- Brooklyn, NY
National Provider Identifier
1609321140
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 2042269
- Practice address
- 197 Highlawn Ave
Brooklyn, NY 11223-2647 - Phone
- (347) 492-7717
- Fax
- (347) 492-7718
- NPI assigned
- Aug 24, 2016
- Last updated
- Aug 24, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 2042269 | NY | Primary |
Addresses
Primary practice location
197 Highlawn Ave
Brooklyn, NY 11223-2647
Mailing address
197 Highlawn Ave
Brooklyn, NY 11223-2647
Phone (347) 492-7717
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 813417343 | Other | NY | TAX ID |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2042269 | NY | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sandra Medical Supplies Inc | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Durable Medical Equipment & Medical Supplies
- Brooklyn, NY
- NPI 1942743190
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1471996800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1471996800000",
"number": "1609321140",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "197 HIGHLAWN AVE",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112232647",
"telephone_number": "347-492-7717",
"fax_number": "347-492-7718"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "197 HIGHLAWN AVE",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112232647",
"telephone_number": "347-492-7717",
"fax_number": "347-492-7718"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUREVICH",
"first_name": "MARINA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-08-24",
"last_updated": "2016-08-24",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "NY",
"license": "2042269",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAX ID",
"identifier": "813417343",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.