Individual provider Active NPI

Tawikatou Dollak

  • Registered Nurse
  • New York, NY
National Provider Identifier
1255184594
Registry record updated May 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
8578101 Issued in NY
Practice address
100 Arden St Apt 5D
New York, NY 10040-1508
Phone
(917) 539-8024
NPI assigned
Apr 8, 2024
Last updated
May 3, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 3, 2024

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 8578101 NY Primary

Addresses

Primary practice location

100 Arden St Apt 5D
New York, NY 10040-1508

Mailing address

127 Hoefleys LN
Leonia, NJ 07605-1120
Phone (347) 241-2457

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
8578101NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1712534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714694400000",
    "number": "1255184594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 HOEFLEYS LN",
            "city": "LEONIA",
            "state": "NJ",
            "postal_code": "076051120",
            "telephone_number": "347-241-2457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 ARDEN ST APT 5D",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100401508",
            "telephone_number": "917-539-8024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOLLAK",
        "first_name": "TAWIKATOU",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-04-08",
        "last_updated": "2024-05-03",
        "certification_date": "2024-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "8578101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 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.

Verify at the official NPI Registry.