Individual provider Active NPI

Harris Charles Brustein, MD

  • Ophthalmology Physician
  • New Rochelle, NY
National Provider Identifier
1841386299
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
109441 Issued in NY
Practice address
77 Quaker Ridge Road
Suite 203
New Rochelle, NY 10804-2808
Phone
(914) 235-0022
Fax
(914) 636-2722
NPI assigned
Oct 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 109441 NY Primary

Addresses

Primary practice location

77 Quaker Ridge Road
Suite 203
New Rochelle, NY 10804-2808

Mailing address

77 Quaker Ridge Road
Suite 203
New Rochelle, NY 10804-2808
Phone (914) 235-0022

Other identifiers 2

IdentifierTypeStateIssuer
WS907OtherNYOXFORD
41394OtherNYGHI

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
109441NYMDOphthalmology Physician

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1841386299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 QUAKER RIDGE ROAD",
            "address_2": "SUITE 203",
            "city": "NEW ROCHELLE",
            "state": "NY",
            "postal_code": "108042808",
            "telephone_number": "914-235-0022",
            "fax_number": "914-636-2722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 QUAKER RIDGE ROAD",
            "address_2": "SUITE 203",
            "city": "NEW ROCHELLE",
            "state": "NY",
            "postal_code": "108042808",
            "telephone_number": "914-235-0022",
            "fax_number": "914-636-2722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUSTEIN",
        "first_name": "HARRIS",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NY",
            "license": "109441",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "WS907",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "41394",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Rochelle, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.