Concilium Medical, P.C.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

221545 Issued in NY

Legal business name

CONCILIUM MEDICAL, P.C.

Practice address

1200 Gravesend Neck Rd
Brooklyn, NY 11229-4256

Phone

(718) 332-3555

NPI assigned

May 12, 2006

Organization subpart

No

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

Authorized official

Name

Yaroslav Bukharovich

Title

President

Phone

(718) 938-3564

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Yaneth Estrada, DPM

  • Primary Podiatric Medicine Podiatrist
  • Brooklyn, NY
  • NPI 1922080027
  NPD (past)

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207699200000",
    "number": "1972554285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8420 85TH AVE",
            "city": "WOODHAVEN",
            "state": "NY",
            "postal_code": "114211217",
            "telephone_number": "718-805-6767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 GRAVESEND NECK RD",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112294256",
            "telephone_number": "718-332-3555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONCILIUM MEDICAL, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-12",
        "last_updated": "2008-04-09",
        "status": "A",
        "authorized_official_last_name": "BUKHAROVICH",
        "authorized_official_first_name": "YAROSLAV",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-938-3564"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "221545",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02194865",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melissa Concepcion
• Yesenia Concepcion
• Concerned Medical Care, P. C.
• George Nicholas Concert, OTR/L
• Concetta a. Butera, DC, PC
• Concord Direct, Inc.
• Concord Family Services, Inc.
• Concord Limousine
• Concord Medical Care PC
• Concord Nursing & Rehabilitation Center

• Internal Medicine Physician in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 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.