BLUE GREEN HORIZONS OFFICE BASED SURGERY PLLC (NPI# 1073835641) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073835641 |
| Entity Type | Organization |
| Organization Name | BLUE GREEN HORIZONS OFFICE BASED SURGERY PLLC |
| Practice Address |
200 Brooklyn Ave Brooklyn NY 11213-1908 |
| Practice Telephone | 7184987888 |
| Practice Fax Number | 7186047890 |
| Mailing Telephone | 7184987888 |
| Mailing Fax Number | 7186047890 |
| Enumeration Date | 2010-02-23 |
| Last Update Date | 2010-02-23 |
| Authorized Official Name | SHELBY K. SAMUEL (OWNER) |
| Authorized Official Telephone | 7184987888 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
176352 | NY | Ambulatory Health Care Facilities |
| Street Address |
200 BROOKLYN AVE |
| City | BROOKLYN |
| State | NY |
| Zip Code | 11213-1908 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114947157 | Shelby Kevin Samuel | Internal Medicine | 200 Brooklyn Ave, Brooklyn, NY 11213-1908 | 2006-07-20 |
| 1942686951 | Brooklyn Avenue Medical Pllc | Anesthesiology | 200 Brooklyn Ave, Brooklyn, NY 11213-1908 | 2015-08-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548885262 | Zaire Hairston | Counselor | 1625 President Street Brooklyn, Ny 11213 Apt 3a, 1625 President Street Brooklyn, Ny 11213 Apt 3a, Brooklyn, NY 11213 | 2020-06-09 |
| 1447801394 | Rron Lleshi | Physician Assistant | 1635 Union Street, Apt 1a, Brooklyn, NY 11213 | 2019-09-23 |
| 1639723174 | Jamie Zena Morris | Licensed Vocational Nurse | 1372 Sterling Pl B2, Brooklyn, NY 11213 | 2019-08-01 |
| 1073097572 | Mariia Tonkonog | Specialist | 878 Easetern Pkwy, Brooklyn, NY 11213 | 2018-09-20 |
| 1114413234 | Rimma Salganik | Social Worker | Bright Futures for The Children, 119 Schenectady Ave, Brooklyn, NY 11213 | 2018-07-02 |
| 1861980138 | Ibrahim Elkattawy | Student in an Organized Health Care Education/Training Program | 1545 Atlantic Ave # 11213, Brooklyn, NY 11213 | 2018-04-23 |
| 1528571858 | Rivkah Shuchat | Physical Therapist | Homecare, Brooklyn, NY 11213 | 2017-11-08 |
| 1356854699 | Lisa Watler | Physical Therapy Assistant | 1470 Union Street, Brooklyn, NY 11213 | 2017-11-08 |
| 1962914713 | Rockaway Ave Pharmacy Inc | Pharmacist | 226 Schenectady Ave, Brooklyn, NY 11213 | 2017-11-02 |
| 1649796152 | Janet Agbaku | Registered Nurse | 893 Eastern Parkway, Fl 2, Brooklyn, NY 11213 | 2017-08-16 |
| Find all providers in zip 11213 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811347404 | Wyckoff Doctors | Clinic/Center | 1419 Myrtle Avenue, Wyckoff Doctors, Brooklyn, NY 11237-4512 | 2016-06-15 |
| 1629443353 | Brookdale Family Care Center, Inc. | Clinic/Center | 465 New Lots Avenue At Wyona Street, Bfcc New Lots, Brooklyn, NY 11207-6414 | 2015-12-07 |
| 1144693607 | Doral Medical and Multi Specialty Facility LLC | Clinic/Center | 1797 Pitkin Ave, Brooklyn, NY 11212-7841 | 2015-11-05 |
| 1750791877 | Quick Docs Medical, Pllc | Clinic/Center | 256 Utica Ave, Brooklyn, NY 11213-4029 | 2014-04-28 |
| 1982946877 | Forest Hills Medical & Diagnostic | Clinic/Center | 1735 Pitkin Ave, Brooklyn, NY 11212-6603 | 2013-03-19 |
| 1013293588 | Physio Logic Medicine, P.C. | Clinic/Center | 409 Fulton Street, 2nd Floor, Brooklyn, NY 11201 | 2011-10-28 |
| 1124290291 | Altair Medical, P.C. | Clinic/Center | 1115 Ocean Pkwy Ste 1, Brooklyn, NY 11230-4075 | 2008-03-29 |
| 1609048073 | Shorefront Medical Care | Clinic/Center | 2010 86th St, Brooklyn, NY 11214-3204 | 2008-03-26 |
| 1780895094 | Lyudmila Cavalier Physician PC | Clinic/Center | 9014 Flatlands Ave, Brooklyn, NY 11236-3616 | 2007-05-25 |
| 1821210402 | Crown Heights Medical, P.C. | Clinic/Center | 540 E New York Ave, Brooklyn, NY 11225-4514 | 2007-05-03 |
| 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.