Individual provider Active NPI

Angela Maria Dejesus, BACHELORS

  • Local Education Agency (LEA)
  • Fresh Meadows, NY
National Provider Identifier
1023250313
Registry record updated Apr 1, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Local Education Agency (LEA)Taxonomy code 251300000X
License
457339041 Issued in NY
Practice address
59 - 43 160TH St 2Ndflr
Fresh Meadows, NY 11365-1445
Phone
(347) 368-6505
NPI assigned
Apr 1, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 1, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Local Education Agency (LEA) 251300000X 457339041 NY Primary

Addresses

Primary practice location

59 - 43 160TH St 2Ndflr
Fresh Meadows, NY 11365-1445

Mailing address

5943 160TH St # 2Ndflr
Fresh Meadows, NY 11365-1445

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

LicenseStateTypeSpecialty
457339041NYMDLocal Education Agency (LEA)

NPI Registry JSON

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

{
    "created_epoch": "1238544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1238544000000",
    "number": "1023250313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5943 160TH ST # 2NDFLR",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113651445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "59 - 43 160TH ST 2NDFLR",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113651445",
            "telephone_number": "347-368-6505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEJESUS",
        "first_name": "ANGELA",
        "middle_name": "MARIA",
        "credential": "BACHELORS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-04-01",
        "last_updated": "2009-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251300000X",
            "taxonomy_group": "",
            "desc": "Local Education Agency (LEA)",
            "state": "NY",
            "license": "457339041",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresh Meadows, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2009; 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.