Amy Park

Primary specialty

Early Intervention Provider AgencyTaxonomy code 252Y00000X

Practice address

188 Gates Ave
Malverne, NY 11565-1924

Phone

(917) 770-2204

NPI assigned

Aug 25, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1629849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629849600000",
    "number": "1013684273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "188 GATES AVE",
            "city": "MALVERNE",
            "state": "NY",
            "postal_code": "115651924",
            "telephone_number": "917-770-2204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "188 GATES AVE",
            "city": "MALVERNE",
            "state": "NY",
            "postal_code": "115651924",
            "telephone_number": "917-770-2204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "AMY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-25",
        "last_updated": "2021-08-25",
        "certification_date": "2021-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• North Island Medical PLLC
• Amy O'Connor, LMSW
• Olivias Friends Care Management Agency LLC
• Oprx #11565, LLC (OnPoint Pharmacy of Malverne)
• Ruthann Parise, DPM
• Patricia Ryan-Johnson, LCSW PLLC
• Erica Ashley Pearsall, OTR
• Dilmarys Pena, D.D.S.
• Adrienne Perlaza, M.A. CCC/SLP
• Dawn Victoria Powell

• Early Intervention Provider Agency in Malverne, NY
• Providers in Malverne, NY by specialty
• Early Intervention Provider Agency in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2021; 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.