NPIMap

Organization Active NPI

Medical State of Queens

  • Legal Medicine
  • Rego Park, NY
National Provider Identifier
1184034183
Registry record updated Oct 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Legal MedicineTaxonomy code 173000000X
License
233906 Issued in NY
Legal business name
MEDICAL STATE OF QUEENS
Practice address
8544 66TH Rd
Rego Park, NY 11374-5212
Phone
(718) 565-6050
NPI assigned
Apr 30, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2015

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

Authorized official

Name
Nikolai Lagoduke
Title
Dr
Phone
(718) 554-1150

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Legal MedicineGroup: 193200000X MULTI-SPECIALTY GROUP 173000000X 233906 NY Primary

Addresses

Primary practice location

8544 66TH Rd
Rego Park, NY 11374-5212

Mailing address

8544 66TH Rd
Rego Park, NY 11374-5212
Phone (718) 565-6050

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1398816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444867200000",
    "number": "1184034183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8544 66TH RD",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113745212",
            "telephone_number": "718-565-6050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8544 66TH RD",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113745212",
            "telephone_number": "718-565-6050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL STATE OF QUEENS",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-30",
        "last_updated": "2015-10-15",
        "status": "A",
        "authorized_official_last_name": "LAGODUKE",
        "authorized_official_first_name": "NIKOLAI",
        "authorized_official_title_or_position": "DR",
        "authorized_official_telephone_number": "718-554-1150"
    },
    "taxonomies": [
        {
            "code": "173000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Legal Medicine",
            "state": "NY",
            "license": "233906",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rego Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2015; 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.