Organization Active NPI

Avenue C Medical PC

  • Internal Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1710218193
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
254369 Issued in NY
Legal business name
AVENUE C MEDICAL PC
Practice address
573 McDonald Ave
Brooklyn, NY 11218
Phone
(718) 972-2100
Fax
(718) 972-0044
NPI assigned
Jan 25, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Authorized official

Name
Sayeedus S Salehin, MD
Title
Medical Director
Phone
(718) 972-2100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X 254369 NY Primary

Addresses

Primary practice location

573 McDonald Ave
Brooklyn, NY 11218

Mailing address

573 McDonald Avenue
Brooklyn, NY 11218
Phone (718) 972-2100

Other identifiers 1

IdentifierTypeStateIssuer
254369OtherNYLICENSE

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1264377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1710218193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "573 MCDONALD AVENUE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11218",
            "telephone_number": "718-972-2100",
            "fax_number": "718-972-0044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "573 MCDONALD AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11218",
            "telephone_number": "718-972-2100",
            "fax_number": "718-972-0044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVENUE C MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-25",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "SALEHIN",
        "authorized_official_first_name": "SAYEEDUS",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "718-972-2100",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "254369",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "254369",
            "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 Mar 7, 2023; 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.