Maryam Broukhim MD PC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

MARYAM BROUKHIM MD PC

Practice address

900 Northern Blvd
Great Neck, NY 11021

Phone

(516) 487-3783

NPI assigned

Jan 21, 2010

Organization subpart

No

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

Authorized official

Name

Maryam BroukhimNPI 1558394320

Title

Owner

Phone

(516) 487-3783

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Maryam Broukhim, M.D.

  • Specialist
  • Great Neck, NY
  • NPI 1558394320
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1264032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1518480000000",
    "number": "1770814378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 NORTHERN BLVD",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "11021",
            "telephone_number": "516-487-3783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 NORTHERN BLVD",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "11021",
            "telephone_number": "516-487-3783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARYAM BROUKHIM MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-21",
        "last_updated": "2018-02-13",
        "status": "A",
        "authorized_official_last_name": "BROUKHIM",
        "authorized_official_first_name": "MARYAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "516-487-3783"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elmer Martinez
• Nichol Stephen Martinez, M.D.
• Carlos Anibal Martins, OTRIL CHT
• Tiffany Martos
• Scott E Marwin, MD
• Asher Masih, PA
• John F Mason Jr., RPH
• Patrick M Masone, AU
• Zihan Masood, MD
• Richard Anthony Matano, M.D., F.A.C.S

• Surgery Physician in Great Neck, NY
• Providers in Great Neck, NY by specialty
• Surgery Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.