Healthcare Provider Details

I. General information

NPI: 1558520056
Provider Name (Legal Business Name): PRIME CARE MEDICAL OF BRIGHTON PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2008
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3099 CONEY ISLAND AVE LOWER LEVEL
BROOKLYN NY
11235-5660
US

IV. Provider business mailing address

3099 CONEY ISLAND AVE LOWR LEVEL
BROOKLYN NY
11235-6305
US

V. Phone/Fax

Practice location:
  • Phone: 718-934-1499
  • Fax: 718-934-1449
Mailing address:
  • Phone: 718-934-1499
  • Fax: 718-934-1449

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number242628
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberN005475
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number230830
License Number StateNY

VIII. Authorized Official

Name: IFFAT ARA SADIQUE
Title or Position: PHYSICIAN
Credential: MD
Phone: 718-934-1400