Organization Active NPI

Mohammad M Kamal Physician PC

  • Family Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1699834036
Registry record updated May 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
214302 Issued in NY
Legal business name
MOHAMMAD M KAMAL PHYSICIAN PC
Practice address
79 Church Avenue
Brooklyn, NY 11218
Phone
(718) 431-0009
Fax
(718) 431-0451
NPI assigned
Dec 8, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 17, 2010

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

Authorized official

Name
Mohammad Mostafa Kamal, MD
Title
President
Phone
(718) 431-0009

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 214302 NY Primary

Addresses

Primary practice location

79 Church Avenue
Brooklyn, NY 11218

Mailing address

79 Church Avenue
Brooklyn, NY 11218
Phone (718) 431-0009

Other identifiers 1

IdentifierTypeStateIssuer
02008648MedicaidNY

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1274054400000",
    "number": "1699834036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "79 CHURCH AVENUE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11218",
            "telephone_number": "718-431-0009",
            "fax_number": "718-431-0451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "79 CHURCH AVENUE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11218",
            "telephone_number": "718-431-0009",
            "fax_number": "718-431-0451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOHAMMAD M KAMAL PHYSICIAN PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-08",
        "last_updated": "2010-05-17",
        "status": "A",
        "authorized_official_last_name": "KAMAL",
        "authorized_official_first_name": "MOHAMMAD",
        "authorized_official_middle_name": "MOSTAFA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-431-0009",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "214302",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02008648",
            "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 May 17, 2010; 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.