Active NPI
Anne Niesenbaum, M.D.
- Gynecology Physician
- Mineola, NY
National Provider Identifier
1265501381
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gynecology Physician
- License
- 174021-1
- Practice address
- 135 Mineola Blvd
Mineola, NY 11501-3917 - Phone
- (516) 741-4321
- Fax
- (516) 741-8710
- NPI assigned
- Nov 6, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gynecology Physician | 207VG0400X | 174021-1 | NY | Primary |
Addresses
Primary practice location
135 Mineola Blvd
Mineola, NY 11501-3917
Mailing address
135 Mineola Blvd
Mineola, NY 11501-3917
Phone (516) 741-4321
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 174021-1 | NY | MD | Gynecology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162771200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1211414400000",
"number": "1265501381",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "135 MINEOLA BLVD",
"city": "MINEOLA",
"state": "NY",
"postal_code": "115013917",
"telephone_number": "516-741-4321",
"fax_number": "516-741-8710"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "135 MINEOLA BLVD",
"city": "MINEOLA",
"state": "NY",
"postal_code": "115013917",
"telephone_number": "516-741-4321",
"fax_number": "516-741-8710"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NIESENBAUM",
"first_name": "ANNE",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-06",
"last_updated": "2008-05-22",
"status": "A"
},
"taxonomies": [
{
"code": "207VG0400X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology, Gynecology",
"state": "NY",
"license": "174021-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mineola, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 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.