Individual provider Active NPI

Olivia Ioannou

  • Specialist
  • Bayside, NY
National Provider Identifier
1093170375
Registry record updated Dec 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
807493131 Issued in NY
Practice address
5823 Francis Lewis Blvd
Bayside, NY 11364-1636
Phone
(917) 231-5931
NPI assigned
Dec 30, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 807493131 NY Primary

Addresses

Primary practice location

5823 Francis Lewis Blvd
Bayside, NY 11364-1636

Mailing address

5823 Francis Lewis Blvd
Bayside, NY 11364-1636

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
807493131NYMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1451433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451433600000",
    "number": "1093170375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5823 FRANCIS LEWIS BLVD",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113641636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5823 FRANCIS LEWIS BLVD",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113641636",
            "telephone_number": "917-231-5931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IOANNOU",
        "first_name": "OLIVIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-30",
        "last_updated": "2015-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "807493131",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayside, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2015; 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.