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COMMUNITY MEDICAL DISORDER P.C. NPI 1538506076


NPI Information

NPI: 1538506076
Provider Name: COMMUNITY MEDICAL DISORDER P.C.
Classification: Psychologist - 103TP0016X
Entity Type: Organization

Specialization: Prescribing (Medical)

CLIA Number: 33D2245227

Address:
721 FLUSHING AVE
1ST FLOOR
BROOKLYN, NY
ZIP 11206
Phone: (718) 218-6888
Get Directions

COMMUNITY MEDICAL DISORDER P.C. is a prescribing (medical) psychologist in Brooklyn, NY. The provider is a licensed, doctoral-level psychologist authorized to prescribe and has undergone specialized education and training in preparation for prescriptive practice and has passed an examination accepted by the state board of psychology relevant to establishing competence for prescribing, and has received from the state board of psychology a current certificate granting prescriptive authority, which has not been revoked or suspended. COMMUNITY MEDICAL DISORDER P.C. NPI is 1538506076. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

721 FLUSHING AVE
1ST FLOOR
BROOKLYN, NY
ZIP 11206-419
Phone: (718) 218-6888
Fax: (718) 218-6855

The provider's authorized official is Herbert Morton Meadow .
The authorized official title is President and has the following contact phone number (718) 218-6888.

The CLIA number assigned to this NPI record is 33D2245227 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/23/2013 and was last updated on 7/26/2013.


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
1103TP0016XPsychologistPrescribing (Medical)090294NEW YORKYes

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
1A400067616OTHERNEW YORKMEDICARE PTAN
203345420MEDICAIDNEW 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: 11/14/2023

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.