Individual provider Active NPI

Gaelle Anta Fall-Koffi

  • Case Manager/Care Coordinator
  • Whitestone, NY
National Provider Identifier
1124540794
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
152-53, 10TH Avenue
Suite 201
Whitestone, NY 11357
Phone
(646) 730-2328
NPI assigned
Jul 14, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X NY Primary

Addresses

Primary practice location

152-53, 10TH Avenue
Suite 201
Whitestone, NY 11357

Mailing address

15253 10TH Ave Ste 201
Whitestone, NY 11357-1216
Phone (646) 730-2328

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": "1499990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1124540794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15253 10TH AVE STE 201",
            "city": "WHITESTONE",
            "state": "NY",
            "postal_code": "113571216",
            "telephone_number": "646-730-2328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "152-53, 10TH AVENUE",
            "address_2": "SUITE 201",
            "city": "WHITESTONE",
            "state": "NY",
            "postal_code": "11357",
            "telephone_number": "646-730-2328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FALL-KOFFI",
        "first_name": "GAELLE",
        "middle_name": "ANTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-07-14",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Whitestone, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.