Individual provider Active NPI

Lyudmila Iskhakova, RN

  • Ambulatory Care Registered Nurse
  • Long Island City, NY
National Provider Identifier
1073979605
Registry record updated Jan 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Care Registered NurseTaxonomy code 163WP2201X
License
586140 Issued in NY
Practice address
3711 Queens Blvd
Long Island City, NY 11101-1725
Phone
(718) 361-5100
NPI assigned
Jan 12, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 12, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Care Registered Nurse 163WP2201X 586140 NY Primary

Addresses

Primary practice location

3711 Queens Blvd
Long Island City, NY 11101-1725

Mailing address

3711 Queens Blvd
Long Island City, NY 11101-1725
Phone (718) 361-5100

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
586140NYMDAmbulatory Care Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1452556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452556800000",
    "number": "1073979605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3711 QUEENS BLVD",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111011725",
            "telephone_number": "718-361-5100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3711 QUEENS BLVD",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111011725",
            "telephone_number": "718-361-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISKHAKOVA",
        "first_name": "LYUDMILA",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-01-12",
        "last_updated": "2016-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP2201X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Ambulatory Care",
            "state": "NY",
            "license": "586140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Island City, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2016; 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.