Active NPI
Candace Alexis Reuben
- Psychiatric/Mental Health Nurse Practitioner
- Elmhurst, NY
National Provider Identifier
1205268638
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- 013095
- Practice address
- 7901 Broadway
Elmhurst, NY 11373-1329 - Phone
- (718) 334-3670
- NPI assigned
- Aug 8, 2013
- Last updated
- Apr 13, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 013095 | CT | Primary |
Addresses
Primary practice location
7901 Broadway
Elmhurst, NY 11373-1329
Mailing address
7901 Broadway
Elmhurst, NY 11373-1329
Phone (718) 334-3670
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 013095 | CT | MD | Psychiatric/Mental Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1375920000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1712966400000",
"number": "1205268638",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7901 BROADWAY",
"city": "ELMHURST",
"state": "NY",
"postal_code": "113731329",
"telephone_number": "718-334-3670"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7901 BROADWAY",
"city": "ELMHURST",
"state": "NY",
"postal_code": "113731329",
"telephone_number": "718-334-3670"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REUBEN",
"first_name": "CANDACE",
"middle_name": "ALEXIS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-08-08",
"last_updated": "2024-04-13",
"certification_date": "2024-04-13",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "CT",
"license": "013095",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Elmhurst, NY
- Responsive Healthcare Solutions Inc
- Cynthia Restrepo
- Jorge J Restrepo, R.PH.
- Pablo A Restrepo, PHARM.D
- Retina & Ophthalmology Services of New York PLLC
- Juan Carlos Revelli, NURSE PRACTITIONER
- Jorge Manuel Revelo Escobar, MD
- Julianne Francesca Flores Reyes
- Julio Reyes, NP
- Paolo Angelo Santos Reyes, BSN, RN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.