Active NPI
Alla Vasserman
- Health Service Clinic/Center
- Brooklyn, NY
National Provider Identifier
1770953093
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Health Service Clinic/Center
- License
- 684403
- Practice address
- 2934 Brighton 4TH St
Apt 5
Brooklyn, NY 11235-8527 - Phone
- (347) 476-4256
- NPI assigned
- Sep 29, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Health Service Clinic/Center | 261QH0100X | 684403 | NY | Primary |
Addresses
Primary practice location
2934 Brighton 4TH St
Apt 5
Brooklyn, NY 11235-8527
Mailing address
2934 Brighton 4 STR
Apt 5
Brooklyn, NY 11235
Phone (347) 476-4256
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 102471064 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 684403 | NY | MD | Health Service Clinic/Center |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1443484800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1443484800000",
"number": "1770953093",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2934 BRIGHTON 4 STR",
"address_2": "APT 5",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "11235",
"telephone_number": "347-476-4256"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2934 BRIGHTON 4TH ST",
"address_2": "APT 5",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112358527",
"telephone_number": "347-476-4256"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VASSERMAN",
"first_name": "ALLA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-09-29",
"last_updated": "2015-09-29",
"status": "A"
},
"taxonomies": [
{
"code": "261QH0100X",
"taxonomy_group": "",
"desc": "Clinic/Center, Health Service",
"state": "NY",
"license": "684403",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "102471064",
"state": "NY"
}
],
"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 Sep 29, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.