Edward Shalts Medical PC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

209237 Issued in NY

Legal business name

EDWARD SHALTS MEDICAL PC

Practice address

9732 63Rd Rd
Rego Park, NY 11374-1639

Phone

(718) 275-2224

NPI assigned

Nov 23, 2011

Organization subpart

No

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

Authorized official

Name

Edward Shalts

Title

President

Phone

(718) 275-2224

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1322006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1322006400000",
    "number": "1285901900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9732 63RD RD",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113741639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9732 63RD RD",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113741639",
            "telephone_number": "718-275-2224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDWARD SHALTS MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-23",
        "last_updated": "2011-11-23",
        "status": "A",
        "authorized_official_last_name": "SHALTS",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-275-2224"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "209237",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatry Physician in Rego Park, NY
• Providers in Rego Park, NY by specialty
• Psychiatry Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2011; 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.