Individual provider Active NPI

Adeliya Nasimova, MS ED

  • Early Intervention Provider Agency
  • Forest Hills, NY
National Provider Identifier
1104180033
Registry record updated Jun 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Early Intervention Provider AgencyTaxonomy code 252Y00000X
License
2343916 Issued in NY
Practice address
10310 Queens Blvd Apt 4H
Forest Hills, NY 11375-3190
Phone
(718) 809-2107
NPI assigned
Jun 26, 2012
Last updated
Jun 26, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 26, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Early Intervention Provider Agency 252Y00000X 2343916 NY Primary

Addresses

Primary practice location

10310 Queens Blvd Apt 4H
Forest Hills, NY 11375-3190

Mailing address

10310 Queens Blvd Apt 4H
Forest Hills, NY 11375-3190
Phone (718) 809-2107

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
Master of Science

State licenses

LicenseStateTypeSpecialty
2343916NYMDEarly Intervention Provider Agency

NPI Registry JSON

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

{
    "created_epoch": "1340668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340668800000",
    "number": "1104180033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10310 QUEENS BLVD APT 4H",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113753190",
            "telephone_number": "718-809-2107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10310 QUEENS BLVD APT 4H",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113753190",
            "telephone_number": "718-809-2107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NASIMOVA",
        "first_name": "ADELIYA",
        "credential": "MS ED",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-26",
        "last_updated": "2012-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "NY",
            "license": "2343916",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hills, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2012; 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.