St Albans Medical PC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

1854231 Issued in NY

Legal business name

ST ALBANS MEDICAL PC

Practice address

199-12 Hollis Avenue
1St FL
Jamaica, NY 11412-1232

Phone

(718) 413-5665

Fax

(718) 413-5650

NPI assigned

Oct 17, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Dufreny Alphonse Giloux, MD

Title

Owner

Phone

(718) 413-5665

Specialties & licenses 1

Addresses

Other names 1

• St Albans Medical PC Former legal business name

Locations

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

{
    "created_epoch": "1318809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318809600000",
    "number": "1043595507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19912 HOLLIS AVE",
            "address_2": "1ST FL",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114121232",
            "telephone_number": "718-413-5665",
            "fax_number": "718-413-5650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "199-12 HOLLIS AVENUE",
            "address_2": "1ST FL",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114121232",
            "telephone_number": "718-413-5665",
            "fax_number": "718-413-5650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST ALBANS MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-17",
        "last_updated": "2011-10-17",
        "status": "A",
        "authorized_official_last_name": "GILOUX",
        "authorized_official_first_name": "DUFRENY",
        "authorized_official_middle_name": "ALPHONSE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-413-5665",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NY",
            "license": "1854231",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St Albans Medical PC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2011; 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.