NPIMap

Organization Active NPI

CLB Medical Services PC

  • Internal Medicine Physician
  • New York, NY
National Provider Identifier
1679745277
Registry record updated Apr 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
130612 Issued in NY
Legal business name
CLB MEDICAL SERVICES PC
Practice address
1085 Park Ave
Suite 1N
New York, NY 10128-1168
Phone
(212) 876-1886
NPI assigned
Mar 24, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2008

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

Authorized official

Name
Cordia L Beverley, M.D,
Title
President
Phone
(212) 876-1886

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X 130612 NY Primary

Addresses

Primary practice location

1085 Park Ave
Suite 1N
New York, NY 10128-1168

Mailing address

1085 Park Ave
Suite 1N
New York, NY 10128-1168
Phone (212) 876-1886

National Provider Directory

National Provider Directory

Locations

1085 Park Ave
Ofc 1N
New York, NY 10128
Phone (212) 534-6900

Practitioners & affiliated clinicians

Practitioners 3

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": "1206316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208476800000",
    "number": "1679745277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1085 PARK AVE",
            "address_2": "SUITE 1N",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101281168",
            "telephone_number": "212-876-1886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1085 PARK AVE",
            "address_2": "SUITE 1N",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101281168",
            "telephone_number": "212-876-1886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLB MEDICAL SERVICES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-24",
        "last_updated": "2008-04-18",
        "status": "A",
        "authorized_official_last_name": "BEVERLEY",
        "authorized_official_first_name": "CORDIA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "212-876-1886",
        "authorized_official_credential": "M.D,"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "130612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

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