1110 PENNSYLVANIA AVENUE MEDICAL PLLC – NPI #1730638115
Clinic/Center

1110 PENNSYLVANIA AVENUE MEDICAL PLLC is an AHC clinic located in BROOKLYN, NY. NPPES has assigned the NPI number 1730638115 to 1110 PENNSYLVANIA AVENUE MEDICAL PLLC on September 27, 2016. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 261QU0200X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Urgent Care

The NPI profile was previously updated about 10 years ago on Oct 05, 2016. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for 1110 PENNSYLVANIA AVENUE MEDICAL PLLC below.

NPI Profile for
1110 PENNSYLVANIA AVENUE MEDICAL PLLC

NPI Number
1730638115
Enumeration Date

(more than 9 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
1110 PENNSYLVANIA AVENUE MEDICAL PLLC
Primary location
1110 PENNSYLVANIA AVE
SUITE 5
BROOKLYN, NY 11207-9003
Phone: (646) 942-2842 Fax:
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
JACQUELINE STOREY
PHYSICIAN
Phone: (646) 942-2842
Updated
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QU0200X
- Clinic/Center / Urgent Care (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.