DR. ROOSEVELT BOURSIQUOT


Address: 470 Clarkson Ave, Msc#59, Brooklyn, NY 11203
Phone: 7182707207

DR. ROOSEVELT BOURSIQUOT (NPI# 1013399872) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1013399872
Entity Type Individual
Full Name DR. ROOSEVELT BOURSIQUOT
Credential M.D., M.PHIL
Practice Address 470 Clarkson Ave
Msc#59
Brooklyn
NY 11203
Mailing Address 121 Dekalb Ave
Brooklyn
NY 11201-5425
Practice Telephone 7182707207
Mailing Telephone 7182506946
Enumeration Date 2015-06-29
Last Update Date 2019-07-09
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207R00000X Internal Medicine 287069 NY Allopathic & Osteopathic Physicians
N 208M00000X Hospitalist 287069 NY Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
NY 05234079 05

Provider Secondary Practice Location

Address Telephone Number Fax Number
1 Gustave L Levy Pl, New York, NY 100296504 2122411653 2122896393

Office Location

Street Address 470 CLARKSON AVE
MSC#59
City BROOKLYN
State NY
Zip Code 11203

Providers in the same location

NPI Name Taxonomy Address Enumeration
1205868528 Suny Health Science Center At Bklyn Psychiatry & Neurology 470 Clarkson Ave, Brooklyn, NY 11203-2012 2006-07-07
1407318660 Marie M Clerge Nurse Practitioner 470 Clarkson Ave, Brooklyn, NY 11203-2012 2019-04-04
1659852796 Miriam Olenick Social Worker 470 Clarkson Ave, Brooklyn, NY 11203-2012 2018-08-27
1457856163 Five Towns Physicians PC Internal Medicine 470 Clarkson Ave, Brooklyn, NY 11203-2012 2018-03-26
1891179388 Gowtham Mahalingam Emergency Medicine 470 Clarkson Ave, Brooklyn, NY 11203-2012 2015-07-14
1588077994 Suny Health Science Center At Bklyn Clinic/Center 470 Clarkson Ave, Brooklyn, NY 11203-2012 2014-06-04
1932449378 Denise Castor Occupational Therapist 470 Clarkson Ave, Brooklyn, NY 11203-2012 2013-02-21
1861783474 Lilibeth Geolingo Maduramente Nurse Practitioner 470 Clarkson Ave, Suite C, Brooklyn, NY 11203-2012 2011-04-29
1205139284 Tal Avraham Fligelman Obstetrics & Gynecology 470 Clarkson Ave, Suny Downstate Medical Center, Brooklyn, NY 11203-2012 2010-12-13
1326285008 Maria Elena Godoy Siciliano Dietitian, Registered 470 Clarkson Ave, Brooklyn, NY 11203 2009-01-16
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1023615747 Winnie Ming Wong Dance Therapist 451 Clarkson Ave R Building, Idd/mh Unit, R5west, Brooklyn, NY 11203 2020-10-06
1174134803 Jermiah Jonoah Jones Social Worker 307 E 54th St, 3, Brooklyn, NY 11203 2020-08-14
1780201566 Jesvin Jeyapaulraj Student in an Organized Health Care Education/Training Program 450 Clarkson Avenue, Suny Downstate, General Surgery Department, Brooklyn, NY 11203 2020-06-29
1881219731 Natasha Thomas Specialist 140 East 52nd St Brooklyn, Apt 1r, Brooklyn, NY 11203 2020-06-16
1679197396 Syed Hamza Bin Waqar Student in an Organized Health Care Education/Training Program 450 Clarkson Avenue, Msc 50, Suny Downstate, Brooklyn, NY 11203 2020-05-29
1013536846 Isaak Rubinov Student in an Organized Health Care Education/Training Program 91 E 39th St, Brooklyn, NY 11203 2020-04-12
1932733615 Shade Celestine Specialist 293 East53rd Street, Brooklyn, NY 11203 2020-03-03
1023656147 Shenez Brutus Nurse Practitioner Suny Downstate College of Nursing, 450 Clarkson Avenue, Brooklyn, NY 11203 2019-12-19
1215586425 Terry-ann Lee Registered Nurse 440 East 45th Street, Kings, NY 11203 2019-09-10
1568023828 Mmeyeneabasi David Omede Student in an Organized Health Care Education/Training Program 450 Clarkson Avenue, Suny Downstate Medical Center, Brooklyn, NY 11203 2019-06-26
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Taxonomy Information

Taxonomy Code 207R00000X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine

Taxonomy Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source]
- Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1669099115 East New York Medical Healthcare PC Internal Medicine 2673 Atlantic Ave, Brooklyn, NY 11207-2801 2020-07-01
1083242978 Quratulain Nasir Internal Medicine 8301 Bay Pkwy Apt 603, Brooklyn, NY 11214-2692 2020-03-28
1831723725 Pitkin Medical Office P.C. Internal Medicine 1746 Pitkin Ave Fl 1, Brooklyn, NY 11212-6707 2020-02-28
1083246920 Dora Johnson Internal Medicine 374 Stockholm St # B, Brooklyn, NY 11237-4006 2020-02-09
1245876143 Richard Casseus Internal Medicine 6525 Avenue N, Brooklyn, NY 11234-5622 2019-11-26
1598309569 Md Care Now P.C. Internal Medicine 1849 Utica Ave, Brooklyn, NY 11234-2122 2019-11-03
1609410968 Zaki Nakach, Md PC Internal Medicine 1309 Avenue P Ste 1, Brooklyn, NY 11229-1184 2019-10-30
1881158897 Yuanli Xie Medical PC Internal Medicine 749 61st St Ste 403, Brooklyn, NY 11220-5163 2019-01-23
1689146417 Frederik Peter Lindberg Internal Medicine 30 Garfield Pl Apt 2e, Brooklyn, NY 11215-1963 2018-12-18
1598233033 Greenfield Medical Internal Medicine 1716 E 28th St, Brooklyn, NY 11229-2513 2018-11-02
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Competitor

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City BROOKLYN
Zip Code 11203

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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