21St Avenue Medical Plaza Pc
LBN: 21St Avenue Medical Plaza Pc
21St Avenue Medical Plaza Pc is an health care organization with primary practice located at 2101 E 16Th St , Brooklyn NY 11229-4401. The organization recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation, Allopathic & Osteopathic Physicians / Pain Medicine. Allopathic & Osteopathic Physicians / Family Medicine is the primary health care specialty.
21St Avenue Medical Plaza Pc can be contacted via phone (718) 266-9779, or through Ovshaev, Samira via phone (718) 266-9779.
Contact Information
Primary practice address
2101 E 16Th St
Brooklyn NY 11229-4401
Phone: (718) 266-9779
Fax: (718) 645-6600
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 219865 | New York |
| Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation | 208100000X | 208817 | New York |
| Allopathic & Osteopathic Physicians / Pain Medicine | 208VP0000X | 219865 | New York |
Profile Details
| NPI number | 1134256761 |
|---|---|
| LBN Legal business name | 21St Avenue Medical Plaza Pc |
| DBA Doing business as | |
| Authorized official | Ovshaev, Samira Doctor of Osteopathy (DO) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Feb 28th, 2007 |
| Last updated | Mar 7th, 2023 - about last year |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1134256761 | NPPES |
| New York | Other | 1681P2 | EMPIRE BCBS |
| New York | Other | 219865 | EMPIRE BCBS |
| New York | MEDICAID | 02263427 | EMPIRE BCBS |
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