Active NPI
Alla Gadiyeva, NURSE
- Substance Use Disorder Rehabilitation Clinic/Center
- New York, NY
National Provider Identifier
1003160540
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Substance Use Disorder Rehabilitation Clinic/Center
- License
- 655466-1
- Practice address
- 500 West 57TH Street
New York, NY 10019 - Phone
- (212) 293-3000
- Fax
- (212) 292-8038
- NPI assigned
- Nov 6, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Substance Use Disorder Rehabilitation Clinic/Center | 261QR0405X | 655466-1 | NY | Primary |
Addresses
Primary practice location
500 West 57TH Street
New York, NY 10019
Mailing address
240 Ocean Pkwy
Apt 4C
Brooklyn, NY 11218-3258
Phone (347) 787-1904
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 655466-1 | NY | MD | Substance Use Disorder Rehabilitation Clinic/Center |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1352160000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1352160000000",
"number": "1003160540",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "240 OCEAN PKWY",
"address_2": "APT 4C",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112183258",
"telephone_number": "347-787-1904",
"fax_number": "718-622-2558"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 WEST 57TH STREET",
"city": "NEW YORK",
"state": "NY",
"postal_code": "10019",
"telephone_number": "212-293-3000",
"fax_number": "212-292-8038"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GADIYEVA",
"first_name": "ALLA",
"name_prefix": "Ms.",
"credential": "NURSE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-11-06",
"last_updated": "2012-11-06",
"status": "A"
},
"taxonomies": [
{
"code": "261QR0405X",
"taxonomy_group": "",
"desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
"state": "NY",
"license": "655466-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.