=====================================================
General NPI Number Information
=====================================================
NPI Number | 1205105004
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BP IMMEDIATE MEDICAL CARE, PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/22/2011
-----------------------------------------------------
Last Update Date | 07/01/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3808 14TH AVE
-----------------------------------------------------
City | BROOKLYN
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11218-3610
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 212-257-2424
-----------------------------------------------------
Fax | 929-332-2565
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3808 14TH AVE
-----------------------------------------------------
City | BROOKLYN
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11218-3610
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 718-972-2424
-----------------------------------------------------
Fax | 718-972-7070
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. SAMUEL WERZBERGER
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 718-972-2424
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 174400000X
-----------------------------------------------------
Taxonomy Name | Specialist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 261QU0200X
-----------------------------------------------------
Taxonomy Name | Urgent Care Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------