Inessa Yagudayev OD PC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

INESSA YAGUDAYEV OD PC

Practice address

11156 76TH Dr Uppr Lobby2
Forest Hills, NY 11375-7057

Phone

(347) 605-1828

Fax

(718) 832-5326

NPI assigned

Dec 4, 2017

Organization subpart

No

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

Authorized official

Name

Inessa Yagudayev, OD

Title

Owner

Phone

(347) 605-1828

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1512345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1512345600000",
    "number": "1043725708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2350 WATERS EDGE DRIVE",
            "address_2": "APT 5I",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "11360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11156 76TH DR UPPR LOBBY2",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113757057",
            "telephone_number": "347-605-1828",
            "fax_number": "718-832-5326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INESSA YAGUDAYEV OD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-04",
        "last_updated": "2017-12-04",
        "status": "A",
        "authorized_official_last_name": "YAGUDAYEV",
        "authorized_official_first_name": "INESSA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "347-605-1828",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2017; 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.