Active NPI
Crystal Colon, LMSW
- Social Worker
- New York, NY
National Provider Identifier
1043627268
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 091558
- Practice address
- 2265 3Rd Ave
Boriken Neighborhood Health Center
New York, NY 10035-2231 - Phone
- (212) 289-6650
- Fax
- (212) 360-5088
- NPI assigned
- Jul 21, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 916659022 | NY | |
| Social Worker | 104100000X | 091558 | NY | Primary |
Addresses
Primary practice location
2265 3Rd Ave
Boriken Neighborhood Health Center
New York, NY 10035-2231
Mailing address
2265 3Rd Ave
Boriken Neighborhood Health Center
New York, NY 10035-2231
Phone (212) 289-6650
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00355940 | Medicaid | NY | |
| 1285628552 | Other | NY | AGENCIES |
| WVE061 | Other | NY | MEDICARE # |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 091558 | NY | MD | Social Worker |
| 916659022 | NY | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1405900800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1425859200000",
"number": "1043627268",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2265 3RD AVE",
"address_2": "BORIKEN NEIGHBORHOOD HEALTH CENTER",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100352231",
"telephone_number": "212-289-6650",
"fax_number": "212-360-5088"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2265 3RD AVE",
"address_2": "BORIKEN NEIGHBORHOOD HEALTH CENTER",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100352231",
"telephone_number": "212-289-6650",
"fax_number": "212-360-5088"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLON",
"first_name": "CRYSTAL",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-07-21",
"last_updated": "2015-03-09",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NY",
"license": "916659022",
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NY",
"license": "091558",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00355940",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AGENCIES",
"identifier": "1285628552",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE #",
"identifier": "WVE061",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.