SEA GATE MEDICAL NPI 1316234669

NPI Information

NPI: 1316234669
Provider Name: SEA GATE MEDICAL
Classification: Family Medicine - 207QA0505X
Entity Type: Organization

Specialization: Adult Medicine

Address:
1961 CONEY ISLAND AVE
BROOKLYN, NY
ZIP 11223
Phone: (718) 344-7637
Get Directions

SEA GATE MEDICAL is an adult medicine family medicine in Brooklyn, NY. The provider is the National Uniform Claim Committee (NUCC) recommends code 207QA0505X not be used. Choose a more appropriate code. SEA GATE MEDICAL NPI is 1316234669. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1961 CONEY ISLAND AVE
BROOKLYN, NY
ZIP 11223-328
Phone: (718) 344-7637
Fax: (718) 490-1468

The provider's authorized official is Valentin Pridatko .
The authorized official title is Do and has the following contact phone number (718) 236-5077.

The enumeration date for this NPI number is 7/7/2011 and was last updated on 7/7/2011.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207QA0505X	Family Medicine	Adult Medicine	205927	NEW YORK	Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	018288888537	MEDICAID	NEW 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

NPI Synchronization or Removal

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