Active NPI
Alla Seldina Family Health NP PC
- Registered Nurse
- Staten Island, NY
National Provider Identifier
1053917708
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- Legal business name
- ALLA SELDINA FAMILY HEALTH NP PC
- Practice address
- 2305 Hylan Blvd
Staten Island, NY 10306-3231 - Phone
- (718) 667-0297
- Fax
- (718) 667-1945
- NPI assigned
- Dec 8, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Lyudmila Rozenberg
- Title
- Credentialing Specialist
- Phone
- (718) 667-0297
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | Primary |
Addresses
Primary practice location
2305 Hylan Blvd
Staten Island, NY 10306-3231
Mailing address
2305 Hylan Blvd
Staten Island, NY 10306-3231
Phone (718) 667-0297
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 05184818 | Medicaid | NY |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | practicefusion | Health Information Exchange (HIE) |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY, FL
Enrollment records 2
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Nurse Practitioner
- Staten Island, NY
- NPI 1104908789
FL, Registered Nurse
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1607385600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1607385600000",
"number": "1053917708",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2305 HYLAN BLVD",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103063231",
"telephone_number": "718-667-0297",
"fax_number": "718-667-1945"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2305 HYLAN BLVD",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103063231",
"telephone_number": "718-667-0297",
"fax_number": "718-667-1945"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ALLA SELDINA FAMILY HEALTH NP PC",
"organizational_subpart": "NO",
"enumeration_date": "2020-12-08",
"last_updated": "2020-12-08",
"certification_date": "2020-12-08",
"status": "A",
"authorized_official_last_name": "ROZENBERG",
"authorized_official_first_name": "LYUDMILA",
"authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
"authorized_official_telephone_number": "718-667-0297"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Registered Nurse",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "05184818",
"state": "NY"
}
],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "practicefusion",
"affiliation": "N",
"endpointDescription": "electronic",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"address_1": "2305 Hylan Blvd",
"city": "Staten Island",
"state": "NY",
"country_code": "US",
"postal_code": "103063231",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Staten Island, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.