Constractor

Primary specialty

Exclusive Provider OrganizationTaxonomy code 302F00000X

License

824950 Issued in NY

Legal business name

CONSTRACTOR

Practice address

3 Georgia St
Valley Stream, NY 11580-2224

Phone

(347) 962-2006

NPI assigned

Sep 10, 2014

Organization subpart

No

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

Authorized official

Name

Guerline D Gomez, MS

Title

Special Education Teacher

Phone

(347) 962-2006

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1410307200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1410307200000",
    "number": "1184025058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 82",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115820082",
            "telephone_number": "347-962-2006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 GEORGIA ST",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115802224",
            "telephone_number": "347-962-2006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONSTRACTOR",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-10",
        "last_updated": "2014-09-10",
        "status": "A",
        "authorized_official_last_name": "GOMEZ",
        "authorized_official_first_name": "GUERLINE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "SPECIAL EDUCATION TEACHER",
        "authorized_official_telephone_number": "347-962-2006",
        "authorized_official_credential": "MS"
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "NY",
            "license": "824950",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SPECIAL EDUCATION TEACHER",
            "identifier": "103TE1000X",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Exclusive Provider Organization in Valley Stream, NY
• Providers in Valley Stream, NY by specialty
• Exclusive Provider Organization in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2014; 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.