Active NPI
Evette Dejesus
- Health Educator
- Long Island City, NY
National Provider Identifier
1043975519
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Health Educator
- Practice address
- 4209 28TH St
Long Island City, NY 11101-4130 - Phone
- (347) 396-4829
- NPI assigned
- Nov 1, 2021
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Health Educator | 174H00000X | Primary |
Addresses
Primary practice location
4209 28TH St
Long Island City, NY 11101-4130
Mailing address
4209 28TH St # CN11-59
Long Island City, NY 11101-4130
Phone (347) 396-4829
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1635724800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1635724800000",
"number": "1043975519",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4209 28TH ST # CN11-59",
"city": "LONG ISLAND CITY",
"state": "NY",
"postal_code": "111014130",
"telephone_number": "347-396-4829"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4209 28TH ST",
"city": "LONG ISLAND CITY",
"state": "NY",
"postal_code": "111014130",
"telephone_number": "347-396-4829"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEJESUS",
"first_name": "EVETTE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-11-01",
"last_updated": "2021-11-01",
"certification_date": "2021-10-15",
"status": "A"
},
"taxonomies": [
{
"code": "174H00000X",
"taxonomy_group": "",
"desc": "Health Educator",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Long Island City, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.