Jerry C. Wachtel M.D.,P.C.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

161249 Issued in NY

Legal business name

JERRY C. WACHTEL M.D.,P.C.

Practice address

8605 Flatlands Ave
Brooklyn, NY 11236-3607

Phone

(718) 257-1500

Fax

(718) 257-6114

NPI assigned

Mar 27, 2006

Organization subpart

No

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

Authorized official

Name

Jerry C. Wachtel, M.D.

Title

President

Phone

(718) 257-1500

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1143417600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214179200000",
    "number": "1750341301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8605 FLATLANDS AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112363607",
            "telephone_number": "718-257-1500",
            "fax_number": "718-257-6114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8605 FLATLANDS AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112363607",
            "telephone_number": "718-257-1500",
            "fax_number": "718-257-6114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JERRY C. WACHTEL M.D.,P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-27",
        "last_updated": "2008-06-23",
        "status": "A",
        "authorized_official_last_name": "WACHTEL",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-257-1500",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "161249",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01014126",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rose Jerome
• Ruth Jerome
• Ygenie Jerome
• Larissa Jerominow
• Elisa Marie Jeronimo, LMSW
• Jerry Uduevbo, M.D., P.C.
• Michele Jerry, LCSW
• Gracie Jersey
• Chavie Jerusalem, MSED
• Gittle Jerusalem

• Family Medicine Physician in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 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.