Individual provider Active NPI

Ivan Luque

  • Behavior Analyst
  • Elmhurst, NY
National Provider Identifier
1245654417
Registry record updated Feb 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Practice address
9424 41St Ave
Elmhurst, NY 11373-1722
Phone
(201) 887-0652
NPI assigned
Feb 9, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X Primary

Addresses

Primary practice location

9424 41St Ave
Elmhurst, NY 11373-1722

Mailing address

9424 41St Ave
Elmhurst, NY 11373-1722
Phone (201) 887-0652

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

NPI Registry JSON

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

{
    "created_epoch": "1391904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391904000000",
    "number": "1245654417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9424 41ST AVE",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113731722",
            "telephone_number": "201-887-0652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9424 41ST AVE",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113731722",
            "telephone_number": "201-887-0652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUQUE",
        "first_name": "IVAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-02-09",
        "last_updated": "2014-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "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 Feb 9, 2014; 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.