Individual provider Active NPI

Kezia A Stephen

  • Specialist
  • Far Rockaway, NY
National Provider Identifier
1295299782
Registry record updated Jan 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Practice address
4419 Rockaway Beach Blvd Apt 2Q
Far Rockaway, NY 11691-1240
Phone
(718) 414-4347
Fax
(718) 284-1724
NPI assigned
Jan 29, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X Primary

Addresses

Primary practice location

4419 Rockaway Beach Blvd Apt 2Q
Far Rockaway, NY 11691-1240

Mailing address

4419 Rockaway Beach Blvd Apt 2Q
Far Rockaway, NY 11691-1240
Phone (718) 414-4347

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

NPI Registry JSON

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

{
    "created_epoch": "1548720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548720000000",
    "number": "1295299782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4419 ROCKAWAY BEACH BLVD APT 2Q",
            "city": "FAR ROCKAWAY",
            "state": "NY",
            "postal_code": "116911240",
            "telephone_number": "718-414-4347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4419 ROCKAWAY BEACH BLVD APT 2Q",
            "city": "FAR ROCKAWAY",
            "state": "NY",
            "postal_code": "116911240",
            "telephone_number": "718-414-4347",
            "fax_number": "718-284-1724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPHEN",
        "first_name": "KEZIA",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-29",
        "last_updated": "2019-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Far Rockaway, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2019; 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.