Provider Demographics
NPI:1881071991
Name:SPECIAL CARE MEDICAL ASSOCIATES, PC
Entity type:Organization
Organization Name:SPECIAL CARE MEDICAL ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROGELIO
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-421-0472
Mailing Address - Street 1:725 E 22ND ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11210-1103
Mailing Address - Country:US
Mailing Address - Phone:718-421-0472
Mailing Address - Fax:
Practice Address - Street 1:249 PENNSYLVANIA AVE
Practice Address - Street 2:SUITE 5
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11207-3436
Practice Address - Country:US
Practice Address - Phone:718-421-0472
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-28
Last Update Date:2015-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction MedicineGroup - Multi-Specialty
No2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction PsychiatryGroup - Multi-Specialty