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LONDON MEDICAL DIAGNOSTIC PC
NPI 1407002702
Internal Medicine in Forest Hills, NY

Active since August 18, 2008CLIA 33D1028107 · Waiver
10525 64TH AVE, FOREST HILLS, NY 11375(718) 459-3494(718) 606-6069 Get Directions Write a Review

NPPES record last updated: June 19, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 19, 2023, Apr 27, 2022 (2 updates tracked since 2022).

About London Medical Diagnostic Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LONDON MEDICAL DIAGNOSTIC PC (NPI 1407002702) is a healthcare organization registered as an internal medicine in Forest Hills, New York and active in the NPI registry since August 2008. The organization holds a CLIA Waiver certificate valid through July 19, 2028, maintains a secondary practice location in Brooklyn, and lists Ilya Y Burshteyn, Md/ceo, as its authorized official.

NPPES Registry Identity

NPI1407002702
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameLONDON MEDICAL DIAGNOSTIC PC
Location Address10525 64TH AVEForest Hills, NY 11375-1640
Mailing Address10525 64th AveForest Hills, NY 11375-1640 · (718) 459-3494 · Fax (718) 606-6069
Phone(718) 459-3494
Fax(718) 606-6069
Organization SubpartNo
Authorized OfficialIlya Y BurshteynMd/ceo · (718) 459-3494
Enumeration DateAugust 18, 2008
Last NPPES UpdateJune 19, 20232 updates tracked since enumeration
NPPES CertifiedJune 19, 2023
✔ NPI 1407002702 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 6

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Also ListedSpecialistTaxonomy 174400000X · License 215638 (NY)
Also ListedPodiatristTaxonomy 213E00000X
Also ListedPhysical TherapistTaxonomy 225100000X
Also ListedPhysician Assistant · MedicalTaxonomy 363AM0700X
Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X
10525 64TH AVE, Forest Hills, NY 11375
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Secondary Practice Location 1

Location 11401 Ocean Ave Ste LDBrooklyn, NY 11230-3998 · Phone (718) 513-4455 · Fax (718) 375-1944

Other Identifiers 1

Medicaid03272777NY

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 33D1028107

London Medical Diagnostic PC · Forest Hills, NY
Active · expires Jul 19, 2028
CLIA Number33D1028107
Laboratory TypePhysician Office
Certificate Effective DateJuly 20, 2026
Certificate Expiration DateJuly 19, 2028
Laboratory DirectorIlya Y. Burshteyn
Laboratory Phone(718) 459-3494
Laboratory LocationLondon Medical Diagnostic PC105-25 64th Ave, Forest Hills, NY 11375
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. ILYA Y BURSHTEYN MD
General Practice
10525 64TH AVE
FOREST HILLS, NY 11375
Queens County (718) 459-3494
JULIA CONNORS
Physician Assistant (Medical)
10525 64TH AVE
FOREST HILLS, NY 11375
Queens County (718) 513-4455
OMICRON MEDICAL PC
Internal Medicine
10525 64TH AVE
FOREST HILLS, NY 11375
Queens County (718) 459-3494
SOFYA BABABEKOVA FNP-C
Nurse Practitioner (Family)
10525 64TH AVE
FOREST HILLS, NY 11375
Queens County (718) 459-3494
MB MEDICAL HEALTHCARE PC
Family Medicine
10525 64TH AVE
FOREST HILLS, NY 11375
Queens County (718) 459-3494

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is London Medical Diagnostic PC's NPI number?

The NPI number for London Medical Diagnostic PC is 1407002702. It was assigned to this organization in the NPPES registry on August 18, 2008.

Where is London Medical Diagnostic PC located?

London Medical Diagnostic PC is located at 10525 64th Ave, Forest Hills, NY 11375. The listed phone number is (718) 459-3494.

What is London Medical Diagnostic PC's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Does London Medical Diagnostic PC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 33D1028107) is associated with this NPI, valid through July 19, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for London Medical Diagnostic PC was last updated on June 19, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.