Organization Active NPI

Sha-Boss P

  • Geriatric Medicine (Internal Medicine) Physician
  • Brooklyn, NY
National Provider Identifier
1760118624
Registry record updated Jul 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
Legal business name
SHA-BOSS P
Practice address
660 Louisiana Ave
Brooklyn, NY 11239-1526
Phone
(718) 669-7100
NPI assigned
Jul 25, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2022

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

Authorized official

Name
Dr. Hanan Miller, MDNPI 1437143377
Title
Owner
Phone
(718) 377-7988

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0300X Primary

Addresses

Primary practice location

660 Louisiana Ave
Brooklyn, NY 11239-1526

Mailing address

3715 Bedford Ave
Brooklyn, NY 11229-1703
Phone (718) 377-7988

National Provider Directory

National Provider Directory

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": "1658707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658707200000",
    "number": "1760118624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3715 BEDFORD AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112291703",
            "telephone_number": "718-377-7988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "660 LOUISIANA AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112391526",
            "telephone_number": "718-669-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHA-BOSS P",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-25",
        "last_updated": "2022-07-25",
        "certification_date": "2022-07-25",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "HANAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-377-7988",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "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 Jul 25, 2022; 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.