Individualized Family Care LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

INDIVIDUALIZED FAMILY CARE LLC

Practice address

12-22 30TH Ave
Apt 4H
Astoria, NY 11102

Phone

(347) 369-2733

NPI assigned

Feb 19, 2016

Last updated

Jun 20, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Yocheved Polishuk, MS

Title

Owner/Practice Manager

Phone

(347) 369-2733

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1455840000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466380800000",
    "number": "1295194116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12-22 30TH AVE",
            "address_2": "4 H",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "11102",
            "telephone_number": "347-369-2733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12-22 30TH AVE",
            "address_2": "APT 4H",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "11102",
            "telephone_number": "347-369-2733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIVIDUALIZED FAMILY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-19",
        "last_updated": "2016-06-20",
        "status": "A",
        "authorized_official_last_name": "POLISHUK",
        "authorized_official_first_name": "YOCHEVED",
        "authorized_official_title_or_position": "OWNER/PRACTICE MANAGER",
        "authorized_official_telephone_number": "347-369-2733",
        "authorized_official_credential": "MS"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2016; 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.