214-18 Hillside Ave

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Legal business name

214-18 HILLSIDE AVE

Practice address

21418 Hillside Ave
Queens Village, NY 11427-1808

Phone

(646) 331-7345

NPI assigned

May 19, 2013

Organization subpart

No

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

Authorized official

Name

Gracemon Kuriakose

Title

Ceo

Phone

(646) 331-7345

Specialties & licenses 9

Addresses

Tax ID family

214-18 Hillside Ave2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Genesis Medical Services

  • Speech-Language Pathologist
  • Queens Village, NY
  • NPI 1760828537
  NPD tax ID

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

{
    "created_epoch": "1368921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1368921600000",
    "number": "1063858991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21418 HILLSIDE AVE",
            "city": "QUEENS VILLAGE",
            "state": "NY",
            "postal_code": "114271808",
            "telephone_number": "646-331-7345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21418 HILLSIDE AVE",
            "city": "QUEENS VILLAGE",
            "state": "NY",
            "postal_code": "114271808",
            "telephone_number": "646-331-7345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "214-18 HILLSIDE AVE",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-19",
        "last_updated": "2013-05-19",
        "status": "A",
        "authorized_official_last_name": "KURIAKOSE",
        "authorized_official_first_name": "GRACEMON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "646-331-7345"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist/Technologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "227800000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Respiratory Therapist, Certified",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• 1 Nyc Empire Trans Inc.
• 222 Jamaica Drug LLC
• 222 Jamaica Economy Drug
• 222 Jamaica Economy Drug Inc
• A Flash of Hair
• Fairooz Abida, MD

• Speech-Language Pathologist in Queens Village, NY
• Providers in Queens Village, NY by specialty
• Speech-Language Pathologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2013; 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.