Organization Active NPI

Elmhurst Ave Medical Diagnostic, P.C.

  • Cardiovascular Disease Physician
  • Jackson Heights, NY
National Provider Identifier
1255508495
Registry record updated May 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
ELMHURST AVE MEDICAL DIAGNOSTIC, P.C.
Practice address
9018 Elmhurst Ave
2ND Floor
Jackson Heights, NY 11372-7936
Phone
(718) 779-1992
Fax
(718) 779-1994
NPI assigned
May 15, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 15, 2008

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

Authorized official

Name
Mr. Ralph Lanoue
Title
Executive Director
Phone
(718) 779-1992

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0000X Primary

Addresses

Primary practice location

9018 Elmhurst Ave
2ND Floor
Jackson Heights, NY 11372-7936

Mailing address

9018 Elmhurst Ave
2ND Floor
Jackson Heights, NY 11372-7936
Phone (718) 779-1992

National Provider Directory

National Provider Directory

Locations

9018 Elmhurst Ave
#2
Jackson Heights, NY 11372
Phone (718) 396-4434

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1210809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210809600000",
    "number": "1255508495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9018 ELMHURST AVE",
            "address_2": "2ND FLOOR",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "113727936",
            "telephone_number": "718-779-1992",
            "fax_number": "718-779-1994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9018 ELMHURST AVE",
            "address_2": "2ND FLOOR",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "113727936",
            "telephone_number": "718-779-1992",
            "fax_number": "718-779-1994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELMHURST AVE MEDICAL DIAGNOSTIC, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-15",
        "last_updated": "2008-05-15",
        "status": "A",
        "authorized_official_last_name": "LANOUE",
        "authorized_official_first_name": "RALPH",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "718-779-1992",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson Heights, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2008; 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.