SOUTH SHORE OSTEOPATHIC MEDICINE P.C. (NPI# 1063768174) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063768174 |
| Entity Type | Organization |
| Organization Name | SOUTH SHORE OSTEOPATHIC MEDICINE P.C. |
| Practice Address |
2409 Ocean Ave Unit 1f Brooklyn NY 11229-3576 |
| Practice Telephone | 7184447774 |
| Practice Fax Number | 7184447775 |
| Mailing Telephone | 7184447774 |
| Mailing Fax Number | 7184447775 |
| Enumeration Date | 2012-07-26 |
| Last Update Date | 2019-10-04 |
| Authorized Official Name | DR. MICHAEL YURYEV (PRESIDENT) |
| Authorized Official Telephone | 7184447774 |
| Authorized Official Credential | DO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
254873 | NY | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | MEDICARE PTAN | A100073001 | 01 |
| Street Address |
2409 OCEAN AVE UNIT 1F |
| City | BROOKLYN |
| State | NY |
| Zip Code | 11229-3576 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053324780 | Inna N Yuryev-golger | Psychiatry & Neurology | 2409 Ocean Ave Unit 1f, Brooklyn, NY 11229-3576 | 2006-08-14 |
| 1093138000 | Alina Climova | Physician Assistant | 2409 Ocean Ave Unit 1f, Brooklyn, NY 11229-3576 | 2014-01-27 |
| 1194912907 | Art of Medicine, P.C. | Psychiatry & Neurology | 2409 Ocean Ave Unit 1f, Brooklyn, NY 11229-3576 | 2007-09-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063041291 | Nastasia Shygaieva | Counselor | 2 Ivan Court, House, Brooklyn, NY 11229 | 2020-04-08 |
| 1700430253 | Nicole Komisar | Case Manager/Care Coordinator | 2148 Ocean Avenu Suite 302, Brooklyn, NY 11229 | 2019-08-01 |
| 1639723950 | Refuah Diagnostics LLC | Technician | 1988 East 22nd Street, Ground Floor, Brooklyn, NY 11229 | 2019-07-25 |
| 1235792987 | Igor Kulishov | Counselor | 1623 Kings Highway, Brooklyn, Ny 11229, Brooklyn, NY 11229 | 2019-04-18 |
| 1477016145 | Natalia Roth | Nurse Practitioner | Visiting Nurse Service of New York, 1630 East 15 St, 3 Fl, NY 11229 | 2019-04-10 |
| 1942769930 | 1st Care Nj LLC | Case Management | 3919 Bedford Ave, Brooklyn, NY 11229 | 2019-03-18 |
| 1689138505 | Expert Home Care, Inc. | Home Health Aide | 1906 Kings Highway, 2nd Floor, Brooklyn, NY 11229 | 2019-01-24 |
| 1881167732 | Luba's Homecare Inc. | Home Health | 2518 Ocean Ave., Cellar Floor, Brooklyn, NY 11229 | 2019-01-03 |
| 1073084216 | Gem Therapy LLC | Early Intervention Provider Agency | 1674 East 19th Street, 2fl, Brooklyn, NY 11229 | 2018-12-16 |
| 1316412356 | Rina Barkhordarzadeh | Speech-Language Pathologist | 1925 Stuart Street, Brooklyn, NY 11229 | 2018-10-05 |
| Find all providers in zip 11229 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821601352 | Xian Medical Care PC | Clinic/Center | 2010 Bay Ridge Pkwy, Brooklyn, NY 11204-5925 | 2020-08-25 |
| 1356993976 | Mingzhu Medical Office, P.C. | Clinic/Center | 5615 7th Ave Fl 2, Brooklyn, NY 11220-3509 | 2019-07-13 |
| 1689197451 | Citycare Medical P.C. | Clinic/Center | 4119 18th Ave, Brooklyn, NY 11218-5709 | 2017-07-24 |
| 1316472194 | Aldo Alleva, Md Pllc | Clinic/Center | 36 Skillman Ave, Brooklyn, NY 11211-2204 | 2017-04-28 |
| 1275073207 | K Medical Office PC | Clinic/Center | 7315 5th Ave, Brooklyn, NY 11209-7364 | 2017-02-23 |
| 1760921712 | Larimar Family Np Services, Pllc | Clinic/Center | 173 Bay 13th St, Brooklyn, NY 11214-5805 | 2017-02-22 |
| 1700337524 | Yunique Desire-brisard Fnp,lnc | Clinic/Center | 1339 E 104th St, Brooklyn, NY 11236-4507 | 2016-10-17 |
| 1821461898 | John Hon Do Pllc | Clinic/Center | 831 56th St Bsmt, Brooklyn, NY 11220-3695 | 2015-11-12 |
| 1437528171 | Flize Annevo Bryan | Clinic/Center | 721 E 22nd St, Brooklyn, NY 11210-1103 | 2015-09-23 |
| 1992188981 | M&h Family Healthcare, Pllc | Clinic/Center | 562 E 93rd St, Brooklyn, NY 11236-1102 | 2015-07-08 |
| Find all providers in BROOKLYN | ||||
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| 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.