NPIMap

Organization Active NPI

Southeast Medical

  • Internal Medicine Physician
  • Brewster, NY
National Provider Identifier
1942396247
Registry record updated Jun 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
158219 Issued in NY
Legal business name
SOUTHEAST MEDICAL
Practice address
1663 Route 22
Brewster, NY 10509-4048
Phone
(845) 278-6625
NPI assigned
Oct 5, 2006
Last updated
Jun 5, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2008

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

Authorized official

Name
Nilo Herrera, MDNPI 1932108834
Title
President
Phone
(845) 278-9137

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 158219 NY Primary

Addresses

Primary practice location

1663 Route 22
Brewster, NY 10509-4048

Mailing address

1663 Route 22
Brewster, NY 10509-4048
Phone (845) 278-6625

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212624000000",
    "number": "1942396247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1663 ROUTE 22",
            "city": "BREWSTER",
            "state": "NY",
            "postal_code": "105094048",
            "telephone_number": "845-278-6625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1663 ROUTE 22",
            "city": "BREWSTER",
            "state": "NY",
            "postal_code": "105094048",
            "telephone_number": "845-278-6625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEAST MEDICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-05",
        "last_updated": "2008-06-05",
        "status": "A",
        "authorized_official_last_name": "HERRERA",
        "authorized_official_first_name": "NILO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "845-278-9137",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "158219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brewster, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2008; 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.