51 John Street Medical PC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

51 JOHN STREET MEDICAL PC

Practice address

51 John St Ste 4
Babylon, NY 11702-2928

Phone

(631) 661-0400

Fax

(631) 661-0463

NPI assigned

Feb 9, 2011

Organization subpart

No

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

Authorized official

Name

Ms. Teresa A Fuller

Title

Office Manager

Phone

(631) 661-0400

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

{
    "created_epoch": "1297209600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595376000000",
    "number": "1306142245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 JOHN ST",
            "address_2": "SUITE 4",
            "city": "BABYLON",
            "state": "NY",
            "postal_code": "117022928",
            "telephone_number": "631-669-0500",
            "fax_number": "631-661-0463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 JOHN ST STE 4",
            "city": "BABYLON",
            "state": "NY",
            "postal_code": "117022928",
            "telephone_number": "631-661-0400",
            "fax_number": "631-661-0463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "51 JOHN STREET MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-09",
        "last_updated": "2020-07-22",
        "certification_date": "2020-07-22",
        "status": "A",
        "authorized_official_last_name": "FULLER",
        "authorized_official_first_name": "TERESA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "631-661-0400",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "BABYLON",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "BABYLON",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "BABYLON",
            "address_1": "51 John St Ste 4",
            "city": "Babylon",
            "state": "NY",
            "country_code": "US",
            "postal_code": "117022928",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2020; 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.