BROOKLYN SPINE AND SPORTS MEDICINE P.C.


Address: 415 Grand New York Street, Apt E1707, New York, NY 10002
Phone: 4432555130

BROOKLYN SPINE AND SPORTS MEDICINE P.C. (NPI# 1184147449) 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) 1184147449
Entity Type Organization
Organization Name BROOKLYN SPINE AND SPORTS MEDICINE P.C.
Practice Address 415 Grand New York Street
Apt E1707
New York
NY 10002
Practice Telephone 4432555130
Enumeration Date 2017-07-19
Last Update Date 2017-10-26
Authorized Official Name JUSTIN MENDOZA (DO)
Authorized Official Telephone 4432555130
Authorized Official Credential DO
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 2081S0010X Physical Medicine & Rehabilitation
Specialization: Sports Medicine
Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
NY DEA NUMBER FM3317256 01

Office Location

Street Address 415 GRAND NEW YORK STREET
APT E1707
City NEW YORK
State NY
Zip Code 10002

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Taxonomy Information

Taxonomy Code 2081S0010X
Grouping Allopathic & Osteopathic Physicians
Classification Physical Medicine & Rehabilitation
Specialization Sports Medicine

Taxonomy Definition

A physician who specializes in Sports Medicine is responsible for continuous care related to the enhancement of health and fitness as well as the prevention of injury and illness. The specialist possesses knowledge and experience in the promotion of wellness and the prevention of injury from many areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation and injuries. It is the goal of a Sports Medicine specialist to improve the healthcare of the individual engaged in physical exercise.
Notes: Source: American Board of Medical Specialties, 2009. www.abms.org [7/1/2009: definition added]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1417593336 Andrew Stephen Ward Physical Medicine & Rehabilitation 295 Madison Ave Rm 1026, New York, NY 10017-7725 2019-11-26
1215341748 Emily Nell Fatakhov Physical Medicine & Rehabilitation 3 E 101st St Lbby 1, New York, NY 10029-6528 2014-06-12
1558594929 Faruk Razzak Physical Medicine & Rehabilitation 150 E 58th St Fl 14, New York, NY 10155-0002 2009-09-01
1285758029 Jason Moss Fritzhand Physical Medicine & Rehabilitation 1776 Broadway Fl 5, New York, NY 10019-2002 2007-03-19
1265540348 Nadya G Swedan Physical Medicine & Rehabilitation 1065 Park Ave, Second Floor, New York, NY 10128-1001 2006-08-28
1154310316 Neal Adam Mesnick Physical Medicine & Rehabilitation 5 W 16th St, New York, NY 10011-6307 2005-10-19
1912909490 Todd R Schlifstein Physical Medicine & Rehabilitation 201 E 69th St, Suite 2c, New York, NY 10021-5471 2005-08-13
1003818584 Gerard P Varlotta Physical Medicine & Rehabilitation 20 E 46th St Rm 304, New York, NY 10017-9286 2005-08-13
1609877703 Jeffrey M Gross Physical Medicine & Rehabilitation 32 Union Sq E, 7th Floor, New York, NY 10003-3209 2005-08-10
1992339212 Donald Jay Zerio Physical Medicine & Rehabilitation 57 W 57th St Fl 15, New York, NY 10019-2832 2020-02-25
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City NEW YORK
Zip Code 10002

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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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