Community Related Services

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

COMMUNITY RELATED SERVICES

Practice address

9907 Queens Blvd
2ND Floor
Rego Park, NY 11374-4512

Phone

(718) 997-1901

Fax

(718) 997-9259

NPI assigned

Nov 30, 2007

Last updated

Nov 30, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Yelena Mamedova-Braz, M.D.

Title

Medical Director

Phone

(718) 997-1901

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1196380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196380800000",
    "number": "1801078894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99-07 QUEENS BLVD",
            "address_2": "2ND FLOOR",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "11374",
            "telephone_number": "718-997-1901",
            "fax_number": "718-997-9259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9907 QUEENS BLVD",
            "address_2": "2ND FLOOR",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113744512",
            "telephone_number": "718-997-1901",
            "fax_number": "718-997-9259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY RELATED SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-30",
        "last_updated": "2007-11-30",
        "status": "A",
        "authorized_official_last_name": "MAMEDOVA-BRAZ",
        "authorized_official_first_name": "YELENA",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "718-997-1901",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01827816",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinic/Center in Rego Park, NY
• Providers in Rego Park, NY by specialty
• Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2007; 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.