Sonoma Medical P.C.

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

Legal business name

SONOMA MEDICAL P.C.

Practice address

21 Washington Ave
Brentwood, NY 11717-3215

Phone

(347) 624-3341

Fax

(347) 789-7415

NPI assigned

Sep 15, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Arkady Yusupov, MD

Title

President

Phone

(347) 624-3341

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1600128000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600128000000",
    "number": "1770198871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1361 BROADWAY APT B32",
            "city": "HEWLETT",
            "state": "NY",
            "postal_code": "115571342",
            "telephone_number": "347-624-3341",
            "fax_number": "347-789-7415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 WASHINGTON AVE",
            "city": "BRENTWOOD",
            "state": "NY",
            "postal_code": "117173215",
            "telephone_number": "347-624-3341",
            "fax_number": "347-789-7415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SONOMA MEDICAL P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-15",
        "last_updated": "2020-09-15",
        "certification_date": "2020-09-15",
        "status": "A",
        "authorized_official_last_name": "YUSUPOV",
        "authorized_official_first_name": "ARKADY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "347-624-3341",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rose Merle Smith, RN
• Ashley Smyth, M.S.L.AC.
• Jessica Solis
• Michael Francis Sommer, RPAC
• Hanna Song, D.D.S.
• Jessica Sorrells
• Claudia Sosa
• South Coast Physical Medicine PC
• South Shore Chiropractic and Physical Therapy
• Robert Scott Southard, D.C.

• Neurology Physician in Brentwood, NY
• Providers in Brentwood, NY by specialty
• Neurology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2020; 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.