Individual provider Active NPI

Elissaveta G Iordanova, LCAT

  • Dance Therapist
  • New York, NY
National Provider Identifier
1265052807
Registry record updated Apr 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dance TherapistTaxonomy code 225600000X
License
002141-1 Issued in NY
Practice address
2588 Ac Powell Blvd Apt 3M
New York, NY 10039-2607
Phone
(917) 848-7199
NPI assigned
Apr 23, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 23, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dance TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225600000X 002141-1 NY Primary

Addresses

Primary practice location

2588 Ac Powell Blvd Apt 3M
New York, NY 10039-2607

Mailing address

2588 Ac Powell Blvd Apt 3M
New York, NY 10039-2607
Phone (917) 848-7199

Other identifiers 1

IdentifierTypeStateIssuer
9046310213OtherNY1199

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
002141-1NYMDDance Therapist

NPI Registry JSON

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

{
    "created_epoch": "1587600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587600000000",
    "number": "1265052807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2588 AC POWELL BLVD APT 3M",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100392607",
            "telephone_number": "917-848-7199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2588 AC POWELL BLVD APT 3M",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100392607",
            "telephone_number": "917-848-7199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IORDANOVA",
        "first_name": "ELISSAVETA",
        "middle_name": "G",
        "credential": "LCAT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-23",
        "last_updated": "2020-04-23",
        "certification_date": "2020-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225600000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dance Therapist",
            "state": "NY",
            "license": "002141-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "1199",
            "identifier": "9046310213",
            "state": "NY"
        }
    ],
    "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 Apr 23, 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.