NPIMap

Organization Active NPI

Interboro Surgical Associates, P.C.

  • Surgery Physician
  • Brooklyn, NY
National Provider Identifier
1679670210
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
222936 Issued in NY
Legal business name
INTERBORO SURGICAL ASSOCIATES, P.C.
Practice address
8318 4TH Ave
Brooklyn, NY 11209-4413
Phone
(718) 748-0500
Fax
(718) 748-5539
NPI assigned
Sep 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Gregory R. Brevetti, M.D.NPI 1619954435
Title
Director
Phone
(718) 748-0500

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
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X 222936 NY Primary

Addresses

Primary practice location

8318 4TH Ave
Brooklyn, NY 11209-4413

Mailing address

8318 4TH Ave
Brooklyn, NY 11209-4413
Phone (718) 748-0500

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": "1158451200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1679670210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8318 4TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112094413",
            "telephone_number": "718-748-0500",
            "fax_number": "718-748-5539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8318 4TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112094413",
            "telephone_number": "718-748-0500",
            "fax_number": "718-748-5539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERBORO SURGICAL ASSOCIATES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BREVETTI",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "718-748-0500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "NY",
            "license": "222936",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 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.