Individual provider Active NPI

Dan Basil Bibera Te Eng Fo, RN

  • Registered Nurse
  • Elmhurst, NY
National Provider Identifier
1184922015
Registry record updated Mar 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
637867-1 Issued in NY
Practice address
8330 Cornish Ave
Elmhurst, NY 11373-3754
Phone
(718) 478-9571
NPI assigned
Mar 1, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 1, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 637867-1 NY Primary

Addresses

Primary practice location

8330 Cornish Ave
Elmhurst, NY 11373-3754

Mailing address

8330 Cornish Ave
Elmhurst, NY 11373-3754
Phone (718) 478-9571

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
Registered Nurse

State licenses

LicenseStateTypeSpecialty
637867-1NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1298937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1298937600000",
    "number": "1184922015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8330 CORNISH AVE",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113733754",
            "telephone_number": "718-478-9571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8330 CORNISH AVE",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113733754",
            "telephone_number": "718-478-9571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TE ENG FO",
        "first_name": "DAN",
        "middle_name": "BASIL BIBERA",
        "name_prefix": "Mr.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-03-01",
        "last_updated": "2011-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "637867-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmhurst, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2011; 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.