Organization
BOOTH MEDICAL ASSOCIATES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERRENCE BRADY MD (ADMINISTRATOR)
(516) 827-9845
Entity
Organization
Contact information
Practice address
5645 MAIN ST, FLUSHING, NY 11355-5045
(718) 670-2236
Mailing address
PO BOX 518, WILLISTON PARK, NY 11596-0518
(516) 827-9845
(516) 827-9871
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
—
—
207N00000X
Dermatology Physician
—
—
207R00000X
Internal Medicine Physician
—
—
207RC0000X
Cardiovascular Disease Physician
—
—
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
—
—
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
—
—
207RG0100X
Gastroenterology Physician
—
—
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
—
—
207RH0003X
Hematology & Oncology Physician
—
—
207RI0008X
Hepatology Physician
Primary
—
—
207RI0200X
Infectious Disease Physician
—
—
207RN0300X
Nephrology Physician
—
—
207RP1001X
Pulmonary Disease Physician
—
—
207RR0500X
Rheumatology Physician
—
—
2084N0400X
Neurology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00923859
—
NY
01
—
W9411
BCBS
NY
Enumeration date
10/14/2005
Last updated
09/11/2025
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