Active NPI
Laurence J Adams, PA
- Physician Assistant
- Bronx, NY
National Provider Identifier
1053435339
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 002403
- Practice address
- 111 East 210TH Street
MMC - Dept. of Medicine
Bronx, NY 10467 - Phone
- (718) 920-2961
- NPI assigned
- Mar 19, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 002403 | NY | Primary |
Addresses
Primary practice location
111 East 210TH Street
MMC - Dept. of Medicine
Bronx, NY 10467
Mailing address
2850 Mead St
Yorktown Heights, NY 10598-2706
Phone (914) 455-2390
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
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 002403 | NY | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174262400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1053435339",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2850 MEAD ST",
"city": "YORKTOWN HEIGHTS",
"state": "NY",
"postal_code": "105982706",
"telephone_number": "914-455-2390",
"fax_number": "718-920-2058"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 EAST 210TH STREET",
"address_2": "MMC - DEPT. OF MEDICINE",
"city": "BRONX",
"state": "NY",
"postal_code": "10467",
"telephone_number": "718-920-2961"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ADAMS",
"first_name": "LAURENCE",
"middle_name": "J",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "002403",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.