Individual provider Active NPI

Janine Marie Testaverde

  • Specialist
  • Wantagh, NY
National Provider Identifier
1023368008
Registry record updated Sep 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
517234111 Issued in NY
Practice address
3445 Edgerton Ave
Wantagh, NY 11793-2940
Phone
(516) 729-8206
NPI assigned
Sep 17, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 17, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 518925111 NY
Specialist 174400000X 517234111 NY Primary

Addresses

Primary practice location

3445 Edgerton Ave
Wantagh, NY 11793-2940

Mailing address

3445 Edgerton Ave
Wantagh, NY 11793-2940
Phone (516) 729-8206

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
517234111NYMDSpecialist
518925111NYMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1347840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347840000000",
    "number": "1023368008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3445 EDGERTON AVE",
            "city": "WANTAGH",
            "state": "NY",
            "postal_code": "117932940",
            "telephone_number": "516-729-8206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3445 EDGERTON AVE",
            "city": "WANTAGH",
            "state": "NY",
            "postal_code": "117932940",
            "telephone_number": "516-729-8206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TESTAVERDE",
        "first_name": "JANINE",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-09-17",
        "last_updated": "2012-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "518925111",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "517234111",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wantagh, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 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.

Verify at the official NPI Registry.