Active NPI
Paul Bamba, M.D.
- Emergency Medicine Physician
- Valley Stream, NY
National Provider Identifier
1154470979
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 221543
- Practice address
- 900 Franklin Ave
Valley Stream, NY 11580-2145 - Phone
- (617) 697-2656
- Fax
- (617) 697-2656
- NPI assigned
- Jan 10, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 221543 | MA | Primary |
Addresses
Primary practice location
900 Franklin Ave
Valley Stream, NY 11580-2145
Mailing address
900 Franklin Ave
Valley Stream, NY 11580
Phone (617) 697-2656
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 221543 | MA | MD | Emergency Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168387200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1230249600000",
"number": "1154470979",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "900 FRANKLIN AVE",
"city": "VALLEY STREAM",
"state": "NY",
"postal_code": "11580",
"telephone_number": "617-697-2656",
"fax_number": "617-697-2656"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "900 FRANKLIN AVE",
"city": "VALLEY STREAM",
"state": "NY",
"postal_code": "115802145",
"telephone_number": "617-697-2656",
"fax_number": "617-697-2656"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAMBA",
"first_name": "PAUL",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-10",
"last_updated": "2008-12-26",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "MA",
"license": "221543",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Valley Stream, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.