Active NPI
Heather Wasserstrom, MD
- Pediatrics Physician
- New York, NY
National Provider Identifier
1154582484
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 273312-1
- Practice address
- 124 W 60TH St
Apt 11a
New York, NY 10023-7451 - Phone
- (201) 280-8993
- NPI assigned
- Jun 19, 2008
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 273312-1 | NY | Primary |
Addresses
Primary practice location
124 W 60TH St
Apt 11a
New York, NY 10023-7451
Mailing address
124 W 60TH St
Apt 11a
New York, NY 10023-7451
Phone (201) 280-8993
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 273312-1 | NY | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1213833600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1476748800000",
"number": "1154582484",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "124 W 60TH ST",
"address_2": "APT 11A",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100237451",
"telephone_number": "201-280-8993"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "124 W 60TH ST",
"address_2": "APT 11A",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100237451",
"telephone_number": "201-280-8993"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WASSERSTROM",
"first_name": "HEATHER",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-06-19",
"last_updated": "2016-10-18",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NY",
"license": "273312-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.