National Provider Identifier Database

21ST AVENUE MEDICAL PLAZA PC
Family Medicine

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine.


Contact Information

21ST AVENUE MEDICAL PLAZA PC
2101 E 16TH ST
BROOKLYN, NY11229-4401
Phone: 718-266-9779
Fax: 718-645-6600
Website:
Specialty Taxonomy Code
* Family Medicine 207Q00000X
Pain Medicine 208VP0000X
Physical Medicine & Rehabilitation 208100000X

* Indicates primary specialty

NPI Profile & details for 21ST AVENUE MEDICAL PLAZA PC

NPI Number 1134256761
Legal business name
LBN
21ST AVENUE MEDICAL PLAZA PC
Authorized official SAMIRA OVSHAEV - (PHYSICIAN)
Entity Organization
Organization subpart No
Enumeration date 02/28/2007
Last updated 03/07/2023 - About 3 years ago
Sole proprietor1 Not specified
Identifiers
  • NY License #: 208817
  • NY License #: 219865
  • NY Medicaid: 02263427
  • NY Other: 1681P2 EMPIRE BCBS
  • NY Other: 219865 LICENSE

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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