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EVERGREEN MEDICAL PLLC NPI 1164664652


NPI Information

NPI: 1164664652
Provider Name: EVERGREEN MEDICAL PLLC
Classification: Psychiatry & Neurology - 2084N0400X
Entity Type: Organization

Specialization: Neurology

Address:
755-759 61ST STREET
BROOKLYN, NY
ZIP 11220
Phone: (718) 680-8881
Get Directions

EVERGREEN MEDICAL PLLC is a neurology psychiatry neurology in Brooklyn, NY. The provider is a Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. EVERGREEN MEDICAL PLLC NPI is 1164664652. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

755-759 61ST STREET
BROOKLYN, NY
ZIP 11220-211
Phone: (718) 680-8881
Fax: (718) 680-7880

The provider's authorized official is May Lin .
The authorized official title is Office Manager and has the following contact phone number (718) 680-8881.

The enumeration date for this NPI number is 3/30/2009 and was last updated on 6/3/2009.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207RN0300XInternal MedicineNephrologyNo
2207RR0500XInternal MedicineRheumatologyNo
32081P2900XPhysical Medicine & RehabilitationPain MedicineNo
42084N0400XPsychiatry & NeurologyNeurologyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
103032428MEDICAIDNEW YORK
202440279MEDICAIDNEW YORK
302681267MEDICAIDNEW YORK
403036766MEDICAIDNEW YORK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.