Provider Demographics
NPI:1043498330
Name:NYC INTERNAL MEDICINE AND NEPHROLOGY, PC
Entity type:Organization
Organization Name:NYC INTERNAL MEDICINE AND NEPHROLOGY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SUZANNAH
Authorized Official - Middle Name:DEBORAH
Authorized Official - Last Name:BERLYNE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-377-2327
Mailing Address - Street 1:125 OCEANA DR E
Mailing Address - Street 2:APT 3H
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-6691
Mailing Address - Country:US
Mailing Address - Phone:718-377-2327
Mailing Address - Fax:718-377-3849
Practice Address - Street 1:3131 KINGS HWY
Practice Address - Street 2:SUITE B8
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-2644
Practice Address - Country:US
Practice Address - Phone:718-377-2327
Practice Address - Fax:718-377-3948
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-08
Last Update Date:2010-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY197128207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY56N671Medicare PIN