Individual provider Active NPI

Harvey Jay Popolow

  • Specialist
  • Glen Oaks, NY
National Provider Identifier
1265794119
Registry record updated Jun 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
406479031 Issued in NY
Practice address
26009 Union Tpke
Glen Oaks, NY 11004-1345
Phone
(516) 395-5584
NPI assigned
Jun 15, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 15, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 406479031 NY Primary

Addresses

Primary practice location

26009 Union Tpke
Glen Oaks, NY 11004-1345

Mailing address

26009 Union Tpke
Glen Oaks, NY 11004-1345
Phone (516) 395-5584

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
406479031NYMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1339718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339718400000",
    "number": "1265794119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26009 UNION TPKE",
            "city": "GLEN OAKS",
            "state": "NY",
            "postal_code": "110041345",
            "telephone_number": "516-395-5584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26009 UNION TPKE",
            "city": "GLEN OAKS",
            "state": "NY",
            "postal_code": "110041345",
            "telephone_number": "516-395-5584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POPOLOW",
        "first_name": "HARVEY",
        "middle_name": "JAY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-06-15",
        "last_updated": "2012-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "406479031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Oaks, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2012; 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.