1110 PENNSYLVANIA AVENUE MEDICAL PLLC (NPI# 1730638115) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730638115 |
| Entity Type | Organization |
| Organization Name | 1110 PENNSYLVANIA AVENUE MEDICAL PLLC |
| Practice Address |
1110 Pennsylvania Ave Suite 5 Brooklyn NY 11207-9003 |
| Practice Telephone | 6469422842 |
| Mailing Telephone | 6469422842 |
| Enumeration Date | 2016-09-27 |
| Last Update Date | 2016-10-05 |
| Authorized Official Name | DR. JACQUELINE STOREY (PHYSICIAN) |
| Authorized Official Telephone | 6469422842 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QU0200X |
Clinic/Center Specialization: Urgent Care |
Ambulatory Health Care Facilities |
| Street Address |
1110 PENNSYLVANIA AVE SUITE 5 |
| City | BROOKLYN |
| State | NY |
| Zip Code | 11207-9003 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184613416 | Natalia Blazhkevich | Dentist | 1110 Pennsylvania Ave, Suite 3, Brooklyn, NY 11207-9061 | 2005-10-19 |
| 1376093674 | Brookdale Rx Inc. | Pharmacy | 1110 Pennsylvania Ave, Brooklyn, NY 11207-9003 | 2016-10-11 |
| 1154752236 | Pala Community Care LLC | Clinic/Center | 1110 Pennsylvania Ave, Brooklyn, NY 11207-9003 | 2013-11-27 |
| 1154653293 | Igor Vaysbaum | Pharmacist | 1110 Pennsylvania Ave, Suite #12, Brooklyn, NY 11207-9003 | 2010-01-30 |
| 1861724908 | Julia Stein | Pharmacist | 1110 Pennsylvania Ave, Suite #12, Brooklyn, NY 11207-9003 | 2010-01-30 |
| 1558533414 | Black Diamond Dental LLP | Dentist | 1110 Pennsylvania Ave, Suite 3, Brooklyn, NY 11207-9061 | 2008-03-31 |
| 1831231729 | Central Optometry PC | Optometrist | 1110 Pennsylvania Ave, Brooklyn, NY 11207-9061 | 2007-02-14 |
| 1609950872 | Boris G Kogan | Dentist | 1110 Pennsylvania Ave, Suite#3, Brooklyn, NY 11207-9061 | 2006-10-24 |
| 1952349318 | Marina Novikova | Pediatrics | 1110 Pennsylvania Ave, Brooklyn, NY 11207-9061 | 2006-06-04 |
| 1396792743 | Alla Glusker | Family Medicine | 1110 Pennsylvania Ave, Brooklyn, NY 11207 | 2006-05-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356817142 | Tajeet Singh | Licensed Practical Nurse | 174 East 51, Brooklyn, NY 11207 | 2018-10-18 |
| 1801306147 | Ebony Herring | Counselor | 2640 Pitkin Avenue, Brooklyn, NY 11207 | 2017-09-30 |
| 1780106153 | Ivonne Perry | Registered Nurse | 35 Mc Clancy Pl, Brooklyn, NY 11207 | 2017-07-07 |
| 1548700925 | Special Medical PC | Family Medicine | 699 B Stanley Avenue, Brooklyn, NY 11207 | 2017-03-03 |
| 1003368333 | Alison Deborah Kahler | Social Worker | 557 Pennsylvania Ave, Room 155, Icl School Based Program At Ps13, Brooklyn, NY 11207 | 2016-11-03 |
| 1942757836 | Melissa Santana | Counselor | Bushwick Child and Family Mental Health Center, 102 Pilling Street, Brooklyn, NY 11207 | 2016-09-08 |
| 1871943050 | Joan Murrell | Licensed Practical Nurse | 297 Bradford St, Brooklyn, NY 11207 | 2016-06-17 |
| 1386019321 | Marta Josephine Jablonka I | Peer Specialist | 137 Dewitt Ave, Brooklyn, NY 11207 | 2015-12-02 |
| 1962877076 | Uche Rosario Oboh | Pharmacist | Nyc Health & Hospitals Gotham Health Center, 2094 Pitkin Avenue, Brooklyn, NY 11207 | 2015-12-01 |
| 1467837997 | Dhalene Wharton | Licensed Practical Nurse | 540 Shefield Ave, Brooklyn, NY 11207 | 2015-07-27 |
| Find all providers in zip 11207 | ||||
| Taxonomy Code | 261QU0200X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Urgent Care |
| Definition to come... |
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|---|---|---|---|---|
| 1619599578 | Rite Medical Care PC | Clinic/Center | 504 Myrtle Ave, Brooklyn, NY 11205-3542 | 2020-05-14 |
| 1851924294 | Tbhc Medical Services PC | Clinic/Center | 514 Fulton Street, Brooklyn, NY 11201 | 2020-02-13 |
| 1811539323 | Asjs Medical, Pllc | Clinic/Center | 1880 Prospect Pl, Brooklyn, NY 11233-4715 | 2019-10-16 |
| 1417517012 | City Medical of Upper East Side, Pllc | Clinic/Center | 1243 Fulton St, Brooklyn, NY 11216-2004 | 2019-06-17 |
| 1427546522 | City Medical of Upper East Side, Pllc | Clinic/Center | 5024 5th Ave, Brooklyn, NY 11220-1909 | 2018-04-25 |
| 1386132470 | City Medical of Upper East Side, Pllc | Clinic/Center | 712 Brighton Beach Ave, Brooklyn, NY 11235-6412 | 2018-04-25 |
| 1669905840 | City Medical of Upper East Side, Pllc | Clinic/Center | 135 Montague Street, Brooklyn, NY 11201 | 2017-04-05 |
| 1982057584 | Brooklyn Urgent Care of Marine Park Pllc | Clinic/Center | 144 E 98th St Ste B, Brooklyn, NY 11212-3808 | 2016-07-19 |
| 1134583099 | Fem Gyn Urgent Care Wellness Pllc | Clinic/Center | 175-7th Avenue, Brooklyn, NY 11215 | 2016-04-07 |
| 1649630682 | Brooklyn Urgent Care of Boro Park Pllc | Clinic/Center | 3909 13th Ave, Brooklyn, NY 11218-3605 | 2016-03-03 |
| 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.