Active NPI
George Malandrakis, CASAC
- Community Health Worker
- Astoria, NY
National Provider Identifier
1063669638
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Worker
- License
- 12383
- Practice address
- 3114 30TH Ave
Astoria, NY 11102-1530 - Phone
- (718) 204-1200
- Fax
- (718) 204-1276
- NPI assigned
- Aug 26, 2008
- 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 |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | 12383 | NY | Primary |
Addresses
Primary practice location
3114 30TH Ave
Astoria, NY 11102-1530
Mailing address
31-14 30TH Avenue
Astoria, NY 11102-1530
Phone (718) 204-1200
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 |
|---|---|---|---|
| 12383 | NY | MD | Community Health Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1219708800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1219708800000",
"number": "1063669638",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "31-14 30TH AVENUE",
"city": "ASTORIA",
"state": "NY",
"postal_code": "111021530",
"telephone_number": "718-204-1200",
"fax_number": "718-204-1276"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3114 30TH AVE",
"city": "ASTORIA",
"state": "NY",
"postal_code": "111021530",
"telephone_number": "718-204-1200",
"fax_number": "718-204-1276"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MALANDRAKIS",
"first_name": "GEORGE",
"name_prefix": "Mr.",
"credential": "CASAC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-08-26",
"last_updated": "2008-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": "NY",
"license": "12383",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Astoria, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.