AMERICAN COMPREHENSIVE HEALTHCARE MEDICAL GROUP. PC (NPI# 1316289853) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316289853 |
| Entity Type | Organization |
| Organization Name | AMERICAN COMPREHENSIVE HEALTHCARE MEDICAL GROUP. PC |
| Practice Address |
5205 Church Ave Brooklyn NY 11203-3513 |
| Practice Telephone | 7186888000 |
| Practice Fax Number | 7186888081 |
| Mailing Telephone | 7186888000 |
| Mailing Fax Number | 7186888081 |
| Enumeration Date | 2013-03-22 |
| Last Update Date | 2013-03-22 |
| Authorized Official Name | DR. KELVIN K JACK (MEDICAL DOCTOR) |
| Authorized Official Telephone | 7186888000 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 002201 | NY | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 03109400 | 05 |
| Street Address |
5205 CHURCH AVE |
| City | BROOKLYN |
| State | NY |
| Zip Code | 11203-3513 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962462416 | Igor Khutoretskiy | Specialist | 5205 Church Ave, Brooklyn, NY 11203-3513 | 2006-03-27 |
| 1144697483 | Ralph Beaubrun | Specialist/Technologist, Other | 5205 Church Ave, Brooklyn, NY 11203-3513 | 2015-08-21 |
| 1114324696 | Afam Family Dental Pllc | Dentist | 5205 Church Ave, Brooklyn, NY 11203-3513 | 2014-11-26 |
| 1033475157 | Lenore Shamah | Dietitian, Registered | 5205 Church Ave, Brooklyn, NY 11203-3513 | 2012-04-03 |
| 1063718435 | Afam Dental Pllc | Dentist | 5205 Church Ave, Brooklyn, NY 11203-3513 | 2011-02-02 |
| 1508176801 | Anna Kapustina | Physician Assistant | 5205 Church Ave, Brooklyn, NY 11203-3513 | 2010-10-20 |
| 1316195530 | Afam Dental Associates P C | Dentist | 5205 Church Ave, 2nd Fl, Brooklyn, NY 11203-3513 | 2008-08-29 |
| 1477723468 | Jane Jaroonnarm | Dentist | 5205 Church Ave, Floor 2, Brooklyn, NY 11203-3513 | 2008-03-05 |
| 1659576726 | Afam Dental Associates, LLP | Dentist | 5205 Church Ave, 2nd Floor, Dental Suite, Brooklyn, NY 11203-3513 | 2007-06-19 |
| 1184830689 | Yamit Busidan | Obstetrics & Gynecology | 5205 Church Ave, Brooklyn, NY 11203-3513 | 2007-05-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023615747 | Winnie Ming Wong | Dance Therapist | 451 Clarkson Ave R Building, Idd/mh Unit, R5west, Brooklyn, NY 11203 | 2020-10-06 |
| 1174134803 | Jermiah Jonoah Jones | Social Worker | 307 E 54th St, 3, Brooklyn, NY 11203 | 2020-08-14 |
| 1780201566 | Jesvin Jeyapaulraj | Student in an Organized Health Care Education/Training Program | 450 Clarkson Avenue, Suny Downstate, General Surgery Department, Brooklyn, NY 11203 | 2020-06-29 |
| 1881219731 | Natasha Thomas | Specialist | 140 East 52nd St Brooklyn, Apt 1r, Brooklyn, NY 11203 | 2020-06-16 |
| 1679197396 | Syed Hamza Bin Waqar | Student in an Organized Health Care Education/Training Program | 450 Clarkson Avenue, Msc 50, Suny Downstate, Brooklyn, NY 11203 | 2020-05-29 |
| 1013536846 | Isaak Rubinov | Student in an Organized Health Care Education/Training Program | 91 E 39th St, Brooklyn, NY 11203 | 2020-04-12 |
| 1932733615 | Shade Celestine | Specialist | 293 East53rd Street, Brooklyn, NY 11203 | 2020-03-03 |
| 1023656147 | Shenez Brutus | Nurse Practitioner | Suny Downstate College of Nursing, 450 Clarkson Avenue, Brooklyn, NY 11203 | 2019-12-19 |
| 1215586425 | Terry-ann Lee | Registered Nurse | 440 East 45th Street, Kings, NY 11203 | 2019-09-10 |
| 1568023828 | Mmeyeneabasi David Omede | Student in an Organized Health Care Education/Training Program | 450 Clarkson Avenue, Suny Downstate Medical Center, Brooklyn, NY 11203 | 2019-06-26 |
| Find all providers in zip 11203 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225639099 | Munisa Mukhamatkulova | Specialist | 1133 E 73rd St, Brooklyn, NY 11234-5409 | 2020-11-06 |
| 1699376251 | Ilona Gamer | Specialist | 2525 E 23rd St, Brooklyn, NY 11235-2505 | 2020-11-02 |
| 1043818545 | Doris Gonzalez-rivera | Specialist | 5610 Avenue T, Brooklyn, NY 11234-4724 | 2020-10-15 |
| 1023625936 | Chaya R Zaetz | Specialist | 797 Maple St, Brooklyn, NY 11203-1312 | 2020-09-24 |
| 1801402060 | Discover Licensed Behavior Analyst Pllc | Specialist | 1350 55th St, Brooklyn, NY 11219-4213 | 2020-09-22 |
| 1114533320 | Yocheved Gershonowitz | Specialist | 1694 E 7th St, Brooklyn, NY 11223-2216 | 2020-09-22 |
| 1992311260 | Sherry A Valentine | Specialist | 1937 Bay Ridge Ave Apt 3r, Brooklyn, NY 11204-4546 | 2020-09-21 |
| 1609481670 | Celina Stolpen | Specialist | 2527 E 27th St, Brooklyn, NY 11235-2016 | 2020-09-15 |
| 1386259760 | Elina Khamish | Specialist | 155 Oceana Dr E Apt 3g, Brooklyn, NY 11235-6684 | 2020-09-11 |
| 1053925263 | Michelle Shneyder | Specialist | 2111 Voorhies Ave, Brooklyn, NY 11235-2817 | 2020-09-04 |
| 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.