NPIMap

Organization Active NPI

Women's Outreach Network

  • Mobile Mammography Clinic/Center
  • Islip Terrace, NY
National Provider Identifier
1205914991
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mobile Mammography Clinic/CenterTaxonomy code 261QR0207X
License
5154206R Issued in NY
Legal business name
WOMEN'S OUTREACH NETWORK
Practice address
54 Lincoln Ave
Islip Terrace, NY 11752-2722
Phone
(631) 581-4171
Fax
(631) 859-4904
NPI assigned
Nov 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Mary M Solomon
Title
Executive Director
Phone
(631) 581-4171

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mobile Mammography Clinic/Center 261QR0207X 5154206R NY Primary

Addresses

Primary practice location

54 Lincoln Ave
Islip Terrace, NY 11752-2722

Mailing address

54 Lincoln Ave
Islip Terrace, NY 11752-2722
Phone (631) 581-4171

Other identifiers 1

IdentifierTypeStateIssuer
01292635MedicaidNY

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1205914991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54 LINCOLN AVE",
            "city": "ISLIP TERRACE",
            "state": "NY",
            "postal_code": "117522722",
            "telephone_number": "631-581-4171",
            "fax_number": "631-859-4904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "54 LINCOLN AVE",
            "city": "ISLIP TERRACE",
            "state": "NY",
            "postal_code": "117522722",
            "telephone_number": "631-581-4171",
            "fax_number": "631-859-4904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOMEN'S OUTREACH NETWORK",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SOLOMON",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "631-581-4171",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QR0207X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology, Mobile Mammography",
            "state": "NY",
            "license": "5154206R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01292635",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Islip Terrace, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.