Individual provider Active NPI

Marifel Mirasol Badoy

  • Registered Nurse
  • Fresh Meadows, NY
National Provider Identifier
1114404365
Registry record updated Jul 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
625024-1 Issued in NY
Practice address
7504 187TH St
Fresh Meadows, NY 11366-1726
Phone
(718) 264-8537
NPI assigned
Jul 20, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 20, 2018

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 625024-1 NY Primary

Addresses

Primary practice location

7504 187TH St
Fresh Meadows, NY 11366-1726

Mailing address

85 Boyd Ave
Jersey City, NJ 07304-1407
Phone (917) 495-8690

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
625024-1NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1532044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532044800000",
    "number": "1114404365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 BOYD AVE",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073041407",
            "telephone_number": "917-495-8690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7504 187TH ST",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113661726",
            "telephone_number": "718-264-8537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BADOY",
        "first_name": "MARIFEL",
        "middle_name": "MIRASOL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-20",
        "last_updated": "2018-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "625024-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresh Meadows, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2018; 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.