NPIMap

Organization Active NPI

William B. Head Jr. M.D. P.C.

  • Neurology Physician
  • Staten Island, NY
National Provider Identifier
1164793089
Registry record updated Jan 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
109042 Issued in NY
Legal business name
WILLIAM B. HEAD JR. M.D. P.C.
Practice address
1100 Clove Rd
Staten Island, NY 10301-3648
Phone
(718) 448-5554
Fax
(718) 448-6741
NPI assigned
Jan 24, 2012
Last updated
Jan 24, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2012

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

Authorized official

Name
Dr. William B. Head Jr., M.D.NPI 1417013160
Title
Doctor
Phone
(718) 448-5554

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 109042 NY Primary
Neurology Physician 2084N0400X 25MA02586900 NJ
Psychiatry Physician 2084P0800X 25MA02586900 NJ
Psychiatry Physician 2084P0800X 109042 NY

Addresses

Primary practice location

1100 Clove Rd
Staten Island, NY 10301-3648

Mailing address

1100 Clove Rd
Staten Island, NY 10301-3648
Phone (718) 448-5554

National Provider Directory

National Provider Directory

Locations

88 University Pl
Ste 703
New York, NY 10003
Phone (212) 620-0978

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1327363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327363200000",
    "number": "1164793089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 CLOVE RD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103013648",
            "telephone_number": "718-448-5554",
            "fax_number": "718-448-6741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 CLOVE RD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103013648",
            "telephone_number": "718-448-5554",
            "fax_number": "718-448-6741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAM B. HEAD JR. M.D. P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-24",
        "last_updated": "2012-01-24",
        "status": "A",
        "authorized_official_last_name": "HEAD",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "718-448-5554",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NY",
            "license": "109042",
            "primary": true
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NJ",
            "license": "25MA02586900",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NJ",
            "license": "25MA02586900",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "109042",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2012; 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.