Clear View NP in Psychiatry PC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

CLEAR VIEW NP IN PSYCHIATRY PC

Practice address

4016 74TH St
Elmhurst, NY 11373-5602

Phone

(718) 682-7090

NPI assigned

Sep 28, 2023

Organization subpart

No

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

Authorized official

Name

Shahruma Islam, NPNPI 1942874771

Title

Owner

Phone

(847) 305-0810

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Shahruma Islam, NURSE PRACTITIONER

  • Registered Nurse
  • New Hyde Park, NY
  • NPI 1942874771

  NY, Psychiatric/Mental Health

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1695859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695859200000",
    "number": "1124807169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 5TH AVE",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110405450",
            "telephone_number": "847-305-0810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4016 74TH ST",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113735602",
            "telephone_number": "718-682-7090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEAR VIEW NP IN PSYCHIATRY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-28",
        "last_updated": "2023-09-28",
        "certification_date": "2023-09-28",
        "status": "A",
        "authorized_official_last_name": "ISLAM",
        "authorized_official_first_name": "SHAHRUMA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "847-305-0810",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatric/Mental Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.