Organization Active NPI

Medical Diagnostic of Brooklyn PLLC

  • Geriatric Physical Therapist
  • Brooklyn, NY
National Provider Identifier
1730414095
Registry record updated Oct 21, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Physical TherapistTaxonomy code 2251G0304X
Legal business name
MEDICAL DIAGNOSTIC OF BROOKLYN PLLC
Practice address
1150 Brighton Beach Ave
1CC
Brooklyn, NY 11235-5901
Phone
(347) 492-4515
Fax
(347) 492-4514
NPI assigned
Oct 5, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2009

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

Authorized official

Name
Mrs. Yelena Linchevskaya
Title
Manager
Phone
(347) 492-4515

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X
Cardiopulmonary Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 2251C2600X
Ergonomics Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 2251E1200X
Geriatric Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 2251G0304X Primary
Orthopedic Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 2251X0800X
Massage TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225700000X

Addresses

Primary practice location

1150 Brighton Beach Ave
1CC
Brooklyn, NY 11235-5901

Mailing address

1150 Brighton Beach Ave
1CC
Brooklyn, NY 11235-5901
Phone (347) 492-4515

National Provider Directory

National Provider Directory

Locations

1150 Brighton Beach Ave
Apt 1CC
Brooklyn, NY 11235
Phone (347) 492-4515

Practitioners & affiliated clinicians

Practitioners 1

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": "1254700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1256083200000",
    "number": "1730414095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 BRIGHTON BEACH AVE",
            "address_2": "1CC",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112355901",
            "telephone_number": "347-492-4515",
            "fax_number": "347-492-4514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 BRIGHTON BEACH AVE",
            "address_2": "1CC",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112355901",
            "telephone_number": "347-492-4515",
            "fax_number": "347-492-4514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL DIAGNOSTIC OF BROOKLYN PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-05",
        "last_updated": "2009-10-21",
        "status": "A",
        "authorized_official_last_name": "LINCHEVSKAYA",
        "authorized_official_first_name": "YELENA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "347-492-4515",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2251C2600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Cardiopulmonary",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2251E1200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Ergonomics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2251G0304X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Geriatrics",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Orthopedic",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Massage Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "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 Oct 21, 2009; 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.