NPIMap

Organization Active NPI

Greene Avenue Medical PC

  • Legal Medicine
  • Brooklyn, NY
National Provider Identifier
1891831988
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Legal MedicineTaxonomy code 173000000X
License
162991 Issued in NY
Legal business name
GREENE AVENUE MEDICAL PC
Practice address
1350 Greene Ave
Brooklyn, NY 11237-4902
Phone
(718) 628-8216
NPI assigned
Jan 29, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Gaston Sterlin
Title
Sole Proprietor
Phone
(718) 628-8216

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Legal MedicineGroup: 193400000X SINGLE SPECIALTY GROUP 173000000X 162991 NY Primary

Addresses

Primary practice location

1350 Greene Ave
Brooklyn, NY 11237-4902

Mailing address

1350 Greene Ave
Brooklyn, NY 11237-4902
Phone (718) 628-8216

Other identifiers 1

IdentifierTypeStateIssuer
00907153MedicaidNY

National Provider Directory

National Provider Directory
Tax ID family
Greene Avenue Medical PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1891831988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 GREENE AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112374902",
            "telephone_number": "718-628-8216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 GREENE AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112374902",
            "telephone_number": "718-628-8216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREENE AVENUE MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "STERLIN",
        "authorized_official_first_name": "GASTON",
        "authorized_official_title_or_position": "SOLE PROPRIETOR",
        "authorized_official_telephone_number": "718-628-8216"
    },
    "taxonomies": [
        {
            "code": "173000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Legal Medicine",
            "state": "NY",
            "license": "162991",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00907153",
            "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 Aug 22, 2020; 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.