South Brooklyn Medical PC

Primary specialty

SpecialistTaxonomy code 174400000X

License

218261 Issued in NY

Legal business name

SOUTH BROOKLYN MEDICAL PC

Practice address

2119 E 15TH St
Brooklyn, NY 11229-4314

Phone

(718) 975-2709

Fax

(718) 975-2709

NPI assigned

Nov 19, 2014

Organization subpart

No

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

Authorized official

Name

Grigory Shtender, MD

Title

President

Phone

(718) 975-2709

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1416355200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1416355200000",
    "number": "1639575665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2119 E 15TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112294314",
            "telephone_number": "718-975-2709",
            "fax_number": "718-975-2709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2119 E 15TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112294314",
            "telephone_number": "718-975-2709",
            "fax_number": "718-975-2709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH BROOKLYN MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-19",
        "last_updated": "2014-11-19",
        "status": "A",
        "authorized_official_last_name": "SHTENDER",
        "authorized_official_first_name": "GRIGORY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-975-2709",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NY",
            "license": "218261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• South Brooklyn Health
• South Brooklyn Health Center
• South Brooklyn Home Physical Therapy PLLC
• South Brooklyn Medical Administrative Services, Inc.
• South Brooklyn Medical Care, PC
• South Brooklyn Medical Practice, PC
• South Brooklyn Nephrology Center Inc
• South Brooklyn Nephrology Center Inc
• South Brooklyn Pharma Corp
• South Brooklyn Psychological Services PLLC

• Specialist in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2014; 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.