Personal Care NP Adult Health Practice PLLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

3053411 Issued in NY

Legal business name

PERSONAL CARE NP ADULT HEALTH PRACTICE PLLC

Practice address

19105 Jamaica Ave
Hollis, NY 11423-2527

Phone

(718) 217-7111

Fax

(718) 217-7113

NPI assigned

Feb 12, 2016

Organization subpart

No

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

Authorized official

Name

Ralph Edouard, ANPNPI 1598058224

Title

Nurse Practioner

Phone

(718) 217-7111

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ralph Edouard, ANP

  • Primary Care Nurse Practitioner
  • Hollis, NY
  • NPI 1598058224
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1455235200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1475798400000",
    "number": "1063871523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19105 JAMAICA AVE",
            "city": "HOLLIS",
            "state": "NY",
            "postal_code": "114232527",
            "telephone_number": "718-217-7111",
            "fax_number": "718-217-7113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19105 JAMAICA AVE",
            "city": "HOLLIS",
            "state": "NY",
            "postal_code": "114232527",
            "telephone_number": "718-217-7111",
            "fax_number": "718-217-7113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERSONAL CARE NP ADULT HEALTH PRACTICE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-12",
        "last_updated": "2016-10-07",
        "status": "A",
        "authorized_official_last_name": "EDOUARD",
        "authorized_official_first_name": "RALPH",
        "authorized_official_title_or_position": "NURSE PRACTIONER",
        "authorized_official_telephone_number": "718-217-7111",
        "authorized_official_credential": "ANP"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NY",
            "license": "3053411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Destanie Perez
• Perfect Age Adult Day Care
• Indrani Persaud, D.O
• Patricia Persaud
• Vivian R I Persaud
• Marie Philemond, OTA
• Erica Pierre
• Nicole Pinkhas
• Mikhail B Pinkhasov, MD
• Margarita Pinkhasova

• Primary Care Clinic/Center in Hollis, NY
• Providers in Hollis, NY by specialty
• Primary Care Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2016; 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.

Verify at the official NPI Registry.