MEDICARE: NOSTRAND COMMUNITY MEDICAL P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	305R00000X	Preferred Provider Organization	226710	NY
2	302R00000X	Health Maintenance Organization	226710	NY

General Provider Information

NPI Number	:	1063424505
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NOSTRAND COMMUNITY MEDICAL P.C.

Provider Business Mailing Address
First Line	:	2968 AVENUE X
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11235-1808
Country	:	US
Telephone Number	:	718-769-4988
Fax Number	:	718-769-4415

Provider Business Practice Location Address
First Line	:	2968 AVENUE X
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11235-1808
Country	:	US
Telephone Number	:	718-769-7988
Fax Number	:	718-769-4415

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	DR. ISMAIL M ELHAM
Credential	:	M.D.
Telephone Number	:	718-769-4988

Provider Enumeration Date	:	08/13/2006
Last Update Date	:	09/11/2025

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Directions to “NOSTRAND COMMUNITY MEDICAL P.C. ” Practice Location

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