Individual provider Active NPI

Vidya Johnson-Sandiford

  • Early Intervention Provider Agency
  • Jamaica, NY
National Provider Identifier
1225307648
Registry record updated Dec 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Early Intervention Provider AgencyTaxonomy code 252Y00000X
License
87950 Issued in NY
Practice address
11927 180TH St
Jamaica, NY 11434-1945
Phone
(718) 926-4017
NPI assigned
Dec 14, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 14, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Early Intervention Provider Agency 252Y00000X 87950 NY Primary

Addresses

Primary practice location

11927 180TH St
Jamaica, NY 11434-1945

Mailing address

11927 180TH St
Jamaica, NY 11434-1945

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

LicenseStateTypeSpecialty
87950NYMDEarly Intervention Provider Agency

NPI Registry JSON

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

{
    "created_epoch": "1323820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323820800000",
    "number": "1225307648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11927 180TH ST",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114341945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11927 180TH ST",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114341945",
            "telephone_number": "718-926-4017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON-SANDIFORD",
        "first_name": "VIDYA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-12-14",
        "last_updated": "2011-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "NY",
            "license": "87950",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamaica, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 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.