Individual provider Active NPI

Irena Israilova, MS GEN AND SPEC ED

  • Student in an Organized Health Care Education/Training Program
  • Forest Hills, NY
National Provider Identifier
1003219635
Registry record updated Sep 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
3568882 Issued in NY
Practice address
6120 Grand Central Pkwy
B1102
Forest Hills, NY 11375-1263
Phone
(646) 420-7735
NPI assigned
Sep 26, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 26, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 3568882 NY Primary
Student in an Organized Health Care Education/Training Program 390200000X NY

Addresses

Primary practice location

6120 Grand Central Pkwy
B1102
Forest Hills, NY 11375-1263

Mailing address

6120 Grand Central Pkwy
B1102
Forest Hills, NY 11375-1263
Phone (646) 420-7735

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
3568882NYMDStudent in an Organized Health Care Education/Training Program

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1411689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411689600000",
    "number": "1003219635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6120 GRAND CENTRAL PKWY",
            "address_2": "B1102",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113751263",
            "telephone_number": "646-420-7735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6120 GRAND CENTRAL PKWY",
            "address_2": "B1102",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113751263",
            "telephone_number": "646-420-7735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISRAILOVA",
        "first_name": "IRENA",
        "name_prefix": "Ms.",
        "credential": "MS GEN AND SPEC ED",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-09-26",
        "last_updated": "2014-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NY",
            "license": "3568882",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NY",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hills, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.