Midwood Complete Medical PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

126720-1 Issued in NY

Legal business name

MIDWOOD COMPLETE MEDICAL PC

Practice address

1723 Elm Ave
Brooklyn, NY 11230-5306

Phone

(718) 421-9630

Fax

(718) 998-9059

NPI assigned

Apr 13, 2010

Organization subpart

No

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

Authorized official

Name

Narcisse Versailles, MD

Title

President

Phone

(718) 421-9630

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1271116800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271116800000",
    "number": "1790001949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1723 ELM AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112305306",
            "telephone_number": "718-421-9630",
            "fax_number": "718-998-9059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1723 ELM AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112305306",
            "telephone_number": "718-421-9630",
            "fax_number": "718-998-9059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWOOD COMPLETE MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-13",
        "last_updated": "2010-04-13",
        "status": "A",
        "authorized_official_last_name": "VERSAILLES",
        "authorized_official_first_name": "NARCISSE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-421-9630",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "126720-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2010; 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.