Brooklyn Select Physician
Clinic/Center in Jamaica, NY. Organization (NPI-2).
NPI number1477888980
StatusActive
Last updated in NPPESFeb 13, 2026
Details
- NPI
- 1477888980
- Entity type
- Organization (NPI-2)
- Legal business name
- Brooklyn Select Physician
- Organization subpart
- No
- Enumeration date
- Oct 16, 2009
- Certification date
- Feb 13, 2026
- Last updated
- Feb 13, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261Q00000X | Clinic/Center | 212345 | NY | Yes |
| 261Q00000X | Clinic/Center | 217560 | NY |
Practice location
170-12 Highland Ave, Suite102Jamaica, NY 11432
Phone 718-233-4966 · Fax 718-622-2323
Mailing address
1078 Fulton Street, 1st FloorBrooklyn, NY 11238
Phone 718-622-2300 · Fax 718-622-2323
Authorized official
Samia Tayab
Ceo
9174056727
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