BROOKLYN ANTI AGING CENTER INC. (NPI# 1477855757) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477855757 |
| Entity Type | Organization |
| Organization Name | BROOKLYN ANTI AGING CENTER INC. |
| Practice Address |
745 64th St Brooklyn NY 11220-4753 |
| Practice Telephone | 7185170665 |
| Enumeration Date | 2010-11-19 |
| Last Update Date | 2010-11-19 |
| Authorized Official Name | SORANG KIM (PRESIDENT) |
| Authorized Official Telephone | 7185170665 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084A0401X |
Psychiatry & Neurology Specialization: Addiction Medicine |
Allopathic & Osteopathic Physicians |
| Street Address |
745 64TH ST |
| City | BROOKLYN |
| State | NY |
| Zip Code | 11220-4753 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689663742 | Alexander Trakhtman | Psychiatry & Neurology | 745 64th St, Brooklyn, NY 11220-4753 | 2005-10-20 |
| 1376151712 | Liana Angelica Hansen | Physician Assistant | 745 64th St, Brooklyn, NY 11220-4745 | 2020-07-22 |
| 1144879099 | Claudya Morin | Student in an Organized Health Care Education/Training Program | 745 64th St, Brooklyn, NY 11220-4745 | 2019-09-04 |
| 1215397260 | Modern Urology Pllc | Urology | 745 64th St, Ste 4, Brooklyn, NY 11220-4745 | 2016-03-03 |
| 1013389089 | Maimonides Medical Center | General Acute Care Hospital | 745 64th St, Brooklyn, NY 11220-4745 | 2015-10-29 |
| 1710399902 | Thais Araujo Fortes | Obstetrics & Gynecology | 745 64th St, Brooklyn, NY 11220 | 2014-05-22 |
| 1023358082 | Rebecca Halton | Physician Assistant | 745 64th St, Brooklyn, NY 11220-4745 | 2013-02-27 |
| 1801180138 | Chang Ho Lee Brooklyn Medical PC | Physical Medicine & Rehabilitation | 745 64th St, 2 Fl, Brooklyn, NY 11220-4745 | 2011-06-03 |
| 1538465729 | 99 Antiaging Management LLC | Psychiatry & Neurology | 745 64th St, Brooklyn, NY 11220-4753 | 2011-02-04 |
| 1205155058 | Infusion Options Inc | Durable Medical Equipment & Medical Supplies | 745 64th St, Brooklyn, NY 11220-4745 | 2010-05-19 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184231797 | Tingting Chen | Nurse Practitioner | 5618 7th Ave Brooklyn, New York, NY 11220 | 2020-09-28 |
| 1194345306 | Laura Cafro | Nurse Practitioner | 150 55 Th St, Brooklyn, NY 11220 | 2020-04-17 |
| 1427680776 | Sfc Orthodontics P.C. | Dentist | 738 58th St., 1st Floor, Brooklyn, NY 11220 | 2020-02-05 |
| 1508405689 | Modern Eyes Optical LLC | Technician/Technologist | 5020 8th Ave, Modern Eyes Optical, Brooklyn, NY 11220 | 2020-01-06 |
| 1700437381 | Gabriella Scaglione | Dental Hygienist | 5800 2nd Ave, Brooklyn, NY 11220 | 2019-09-24 |
| 1316597958 | Labq Clinical Diagnostics LLC Dba Labq Diagnostics | Clinical Medical Laboratory | 140 58th St. Bldg A, Suite 3l, Brooklyn, NY 11220 | 2019-09-16 |
| 1578116265 | Jing Li | Registered Nurse | 59-56 Brooklyn, Kings, NY 11220 | 2019-07-22 |
| 1518520675 | Robert W Tan | Dentist | 3d Dental Implant Center, 5321 7th Avenue, Brooklyn, NY 11220 | 2019-04-15 |
| 1548729775 | Ayah Rashwan | Student in an Organized Health Care Education/Training Program | Nyu Langone Health 150 55th St, Brooklyn, NY 11220 | 2019-03-18 |
| 1477012854 | Jeffrey A Dang | Physician Assistant | 5517 7th Ave. #1f, Brooklyn, NY 11220 | 2019-03-15 |
| Find all providers in zip 11220 | ||||
| Taxonomy Code | 2084A0401X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Addiction Medicine |
| A doctor of osteopathy board eligible/certified in the field of Psychiatry by the American Osteopathic Board of Neurology and Psychiatry is able to obtain a Certificate of Added Qualifications in the field of Addiction Medicine |
| Notes: Source: American Osteopathic Board of Neurology and Psychiatry, 2007 [1/1/2008: definition added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083047658 | Stanley Samuel | Psychiatry & Neurology | 2925 West 19th Street, Brooklyn, NY 11224 | 2013-08-18 |
| 1417070442 | Alejo Parellada | Psychiatry & Neurology | 634 Bergen St, #1, Brooklyn, NY 11238-3450 | 2007-04-06 |
| 1831272947 | Lynda Smith Harris | Psychiatry & Neurology | 760 Broadway Dept Of, Woodhull Medical & Mental Health Center, Brooklyn, NY 11206-5317 | 2006-10-23 |
| 1013923812 | Dean Michael De Crisce | Psychiatry & Neurology | 760 Broadway Ave, Woodhull Medical and Mental Health Center-psychiatry, Brooklyn, NY 11206 | 2006-08-01 |
| 1982665907 | William James Gross | Psychiatry & Neurology | 591 Kingston Ave, Kings County Hosp., Brooklyn, NY 11203-1707 | 2006-03-29 |
| 1821090663 | Mark U Alvarado | Psychiatry & Neurology | 514 49th St, Sunset Terrace Family Health Center, Brooklyn, NY 11220-2010 | 2005-08-11 |
| 1760624241 | Matthew Fiske Warren | Psychiatry & Neurology | 760 Broadway., Woodhull Medical & Mental Health Center, Brooklyn, NY 11206 | 2009-03-31 |
| 1982883963 | Zlatin S Ivanov | Psychiatry & Neurology | 760 Broadway Department of Psychiatry, Woodhull Medical & Mental Health Center, Brooklyn, NY 11206 | 2007-10-26 |
| 1831380989 | Luba Chanin | Psychiatry & Neurology | 132 Graham Ave, Brooklyn, NY 11206-2621 | 2007-08-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942434311 | Daniel Rollings Karlin | Psychiatry & Neurology | 2061 Narragansett Ave # 2, Bronx, NY 10461-1741 | 2009-05-13 |
| 1689820474 | Timothy Koehler Brennan | Psychiatry & Neurology | 1000 10th Ave Fl 8, New York, NY 10019 | 2008-08-12 |
| 1821295577 | Marianne Elizabeth Chai | Psychiatry & Neurology | 226 E 52nd St, Center for Living, New York, NY 10022-6201 | 2007-06-27 |
| 1538371331 | James Peter Wolberg | Psychiatry & Neurology | 1st Ave & 16th St, Bernstein Pavilion, New York, NY 10003 | 2007-05-04 |
| 1578786141 | Bryan James Mcgreal | Psychiatry & Neurology | 324 Lafayette St Fl 8, New York, NY 10012-2726 | 2007-04-11 |
| 1366563652 | Steven Joesph Lee | Psychiatry & Neurology | 130 W. 19th St., Suite Thfb, New York, NY 10011 | 2007-04-03 |
| 1154463511 | Ralph Joseph Carotenuto | Psychiatry & Neurology | 157 South Lake Ave, Albany, NY 12208 | 2007-02-13 |
| 1245383405 | John J Mariani | Psychiatry & Neurology | 51 E 25th St Ste 7e, New York, NY 10010-2945 | 2007-01-19 |
| 1518018662 | Arthur Pellowe | Psychiatry & Neurology | Olmmc, Department of Psychiatry, 4401 Bronx Boulevard, Bronx, NY 10470 | 2007-01-16 |
| 1821148453 | Michael Siegell | Psychiatry & Neurology | 750 Park Ave Ste C, New York, NY 10021-4252 | 2007-01-12 |
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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.