Provider Demographics
NPI:1790915494
Name:CROPSEY MEDICAL CARE PLLC
Entity Type:Organization
Organization Name:CROPSEY MEDICAL CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:OKON
Authorized Official - Middle Name:
Authorized Official - Last Name:UMANA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:914-830-8426
Mailing Address - Street 1:1706 CROPSEY AVENUE SUITE C
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11214
Mailing Address - Country:US
Mailing Address - Phone:914-830-8426
Mailing Address - Fax:718-259-3705
Practice Address - Street 1:1706 CROPSEY AVENUE SUITE C
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11214
Practice Address - Country:US
Practice Address - Phone:914-830-8426
Practice Address - Fax:718-259-3705
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-16
Last Update Date:2010-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY153743208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA400017360Medicare PIN
NYA400022631Medicare PIN
NYA400021189Medicare PIN
NYA400024428Medicare PIN
NYA400019041Medicare PIN
NY90D672Medicare PIN
NYA100017361Medicare PIN
NYA400026960Medicare PIN
NYA400022640Medicare PIN
NYA400019248Medicare UPIN
NYA400022200Medicare PIN
NYA400026439Medicare PIN