MEDICARE: PRIME CARE MEDICAL OF BRIGHTON PC

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	207RC0000X	Cardiovascular Disease Physician	242628	NY
2	213E00000X	Podiatrist	N005475	NY
3	207Q00000X	Family Medicine Physician	230830	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1558520056
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRIME CARE MEDICAL OF BRIGHTON PC

Provider Business Mailing Address
First Line	:	3099 CONEY ISLAND AVE LOWR LEVEL
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11235-6305
Country	:	US
Telephone Number	:	718-934-1499
Fax Number	:	718-934-1449

Provider Business Practice Location Address
First Line	:	3099 CONEY ISLAND AVE
Second Line	:	LOWER LEVEL
City	:	BROOKLYN
State	:	NY
Zip	:	11235-5660
Country	:	US
Telephone Number	:	718-934-1499
Fax Number	:	718-934-1449

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	IFFAT ARA SADIQUE
Credential	:	MD
Telephone Number	:	718-934-1400

Provider Enumeration Date	:	06/09/2008
Last Update Date	:	12/16/2025

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