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:
Map and Directions
Authorized official contact:
Name: Ovshaev, Samira Doctor of Osteopathy (DO)
Phone: (718) 266-9779

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
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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