Medea Medical PC

Primary specialty

Adolescent Medicine (Family Medicine) PhysicianTaxonomy code 207QA0000X

License

285269 Issued in NY

Legal business name

MEDEA MEDICAL PC

Practice address

6829 Springfield Blvd
Oakland GDNS, NY 11364-2632

Phone

(718) 225-3001

Fax

(718) 225-3002

NPI assigned

May 16, 2018

Last updated

May 16, 2018By 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

Dr. Omari Chubinidze, MD

Title

Medical Director

Phone

(718) 225-3001

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1526428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1526428800000",
    "number": "1932699709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6829 SPRINGFIELD BLVD",
            "city": "OAKLAND GDNS",
            "state": "NY",
            "postal_code": "113642632",
            "telephone_number": "718-225-3001",
            "fax_number": "718-225-3002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6829 SPRINGFIELD BLVD",
            "city": "OAKLAND GDNS",
            "state": "NY",
            "postal_code": "113642632",
            "telephone_number": "718-225-3001",
            "fax_number": "718-225-3002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDEA MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-16",
        "last_updated": "2018-05-16",
        "status": "A",
        "authorized_official_last_name": "CHUBINIDZE",
        "authorized_official_first_name": "OMARI",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "718-225-3001",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207QA0000X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adolescent Medicine",
            "state": "NY",
            "license": "285269",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Meekyoung Kim
• Ramy George Geris Massoud
• Nicola (Nick) Roselli, OTR.CHT
• Lisa Marie Schneider, LCSW

• Adolescent Medicine (Family Medicine) Physician in Oakland GDNS, NY
• Providers in Oakland GDNS, NY by specialty
• Adolescent Medicine (Family Medicine) Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2018; 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.