Individual provider Active NPI

Rejeanne Altidor

  • Registered Nurse
  • Elmont, NY
National Provider Identifier
1073760583
Registry record updated Aug 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
439115 Issued in NY
Practice address
2026 Baylis Ave
Elmont, NY 11003-2934
Phone
(516) 502-6023
NPI assigned
Aug 26, 2008
Last updated
Aug 26, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 439115 NY Primary

Addresses

Primary practice location

2026 Baylis Ave
Elmont, NY 11003-2934

Mailing address

2026 Baylis Ave
Elmont, NY 11003-2934
Phone (516) 502-6023

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

LicenseStateTypeSpecialty
439115NYMDRegistered Nurse

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": "1073760583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2026 BAYLIS AVE",
            "city": "ELMONT",
            "state": "NY",
            "postal_code": "110032934",
            "telephone_number": "516-502-6023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2026 BAYLIS AVE",
            "city": "ELMONT",
            "state": "NY",
            "postal_code": "110032934",
            "telephone_number": "516-502-6023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALTIDOR",
        "first_name": "REJEANNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-26",
        "last_updated": "2008-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "439115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmont, 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.

Verify at the official NPI Registry.