NPIMap

Organization Active NPI

Excelsior Integrated Medical Group PLL, Dba Excelsior Laboratory

  • Clinical Medical Laboratory
  • Flushing, NY
National Provider Identifier
1174981880
Registry record updated Feb 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
33D2094053 Issued in NY
Legal business name
EXCELSIOR INTEGRATED MEDICAL GROUP PLL, DBA EXCELSIOR LABORATORY
Practice address
4218 162ND St FL 2
Flushing, NY 11358-4125
Phone
(718) 888-0750
NPI assigned
Feb 9, 2016
Last updated
Feb 9, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2016

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

Authorized official

Name
Dr. Fei Ye, PHD
Title
Lab Manager
Phone
(718) 888-0750

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 33D2094053 NY Primary

Addresses

Primary practice location

4218 162ND St FL 2
Flushing, NY 11358-4125

Mailing address

4218 162ND St FL 2
Flushing, NY 11358-4125
Phone (718) 888-0750

National Provider Directory

National Provider Directory
Tax ID family
Excelsior Integrated Medical Group2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1454976000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1454976000000",
    "number": "1174981880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4218 162ND ST FL 2",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113584125",
            "telephone_number": "718-888-0750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4218 162ND ST FL 2",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113584125",
            "telephone_number": "718-888-0750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXCELSIOR INTEGRATED MEDICAL GROUP PLL, DBA EXCELSIOR LABORATORY",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-09",
        "last_updated": "2016-02-09",
        "status": "A",
        "authorized_official_last_name": "YE",
        "authorized_official_first_name": "FEI",
        "authorized_official_title_or_position": "LAB MANAGER",
        "authorized_official_telephone_number": "718-888-0750",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NY",
            "license": "33D2094053",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 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.

Verify at the official NPI Registry.