Individual provider Active NPI

Carey Eugene Jankiewicz, CASAC-T

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Jamaica, NY
National Provider Identifier
1073769840
Registry record updated Aug 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Practice address
162-24 Jamaica Ave
2ND Floor
Jamaica, NY 11432
Phone
(718) 657-3525
NPI assigned
Aug 13, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 13, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X Primary

Addresses

Primary practice location

162-24 Jamaica Ave
2ND Floor
Jamaica, NY 11432

Mailing address

162-24 Jamaica Ave
2ND Floor
Jamaica, NY 11432
Phone (718) 657-3525

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

NPI Registry JSON

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

{
    "created_epoch": "1218585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1218585600000",
    "number": "1073769840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "162-24 JAMAICA AVE",
            "address_2": "2ND FLOOR",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "11432",
            "telephone_number": "718-657-3525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "162-24 JAMAICA AVE",
            "address_2": "2ND FLOOR",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "11432",
            "telephone_number": "718-657-3525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANKIEWICZ",
        "first_name": "CAREY",
        "middle_name": "EUGENE",
        "name_prefix": "Mr.",
        "credential": "CASAC-T",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-08-13",
        "last_updated": "2008-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamaica, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 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.