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GOTTESMAN MEDICAL PC NPI 1891288676


NPI Information

NPI: 1891288676
Provider Name: GOTTESMAN MEDICAL PC
Classification: Internal Medicine - 207RA0000X
Entity Type: Organization

Specialization: Adolescent Medicine

CLIA Number: 33D2276780

Address:
555 LEFFERTS AVE
BROOKLYN, NY
ZIP 11225
Phone: (646) 757-8751
Get Directions

GOTTESMAN MEDICAL PC is an adolescent medicine internal medicine in Brooklyn, NY. The provider is an internist who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. GOTTESMAN MEDICAL PC NPI is 1891288676. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

555 LEFFERTS AVE
BROOKLYN, NY
ZIP 11225-543
Phone: (646) 757-8751
Fax: (877) 885-5991

The provider's authorized official is Avraham J. Gottesman .
The authorized official title is Vp and has the following contact phone number (646) 757-8751.

The CLIA number assigned to this NPI record is 33D2276780 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/7/2018 and was last updated on 2/4/2020.


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
1207RA0000XInternal MedicineAdolescent Medicine242626NEW 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
103029178MEDICAIDNEW 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.