Active NPI
Premium Health Inc
- Clinic/Center
- Far Rockaway, NY
National Provider Identifier
1336840594
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinic/Center
- Legal business name
- PREMIUM HEALTH INC
- Practice address
- 1212 Seagirt Blvd
Far Rockaway, NY 11691-4551 - Phone
- (718) 407-7300
- NPI assigned
- Mar 15, 2023
- Last updated
- May 15, 2024
- Organization subpart
- Yes
- Parent organization
- PREMIUM HEALTH INC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Galina Hoolin
- Title
- Credentialing Administrator
- Phone
- (718) 407-7300
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | NU | Primary |
Addresses
Primary practice location
1212 Seagirt Blvd
Far Rockaway, NY 11691-4551
Mailing address
365 Route 59
Airmont, NY 10952-3459
Phone (718) 407-7300
National Provider Directory
National Provider Directory- Tax ID family
- Premium Health Inc
- Part of
- Premium Health Inc
Other organizations with this tax ID 3
Organizations that report the same tax identification number in the National Provider Directory.
Locations
1821 Cornaga Ave
Far Rockaway, NY 11691
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1678838400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1715731200000",
"number": "1336840594",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "365 ROUTE 59",
"city": "AIRMONT",
"state": "NY",
"postal_code": "109523459",
"telephone_number": "718-407-7300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1212 SEAGIRT BLVD",
"city": "FAR ROCKAWAY",
"state": "NY",
"postal_code": "116914551",
"telephone_number": "718-407-7300"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PREMIUM HEALTH INC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "PREMIUM HEALTH INC",
"enumeration_date": "2023-03-15",
"last_updated": "2024-05-15",
"certification_date": "2024-05-15",
"status": "A",
"authorized_official_last_name": "HOOLIN",
"authorized_official_first_name": "GALINA",
"authorized_official_title_or_position": "CREDENTIALING ADMINISTRATOR",
"authorized_official_telephone_number": "718-407-7300"
},
"taxonomies": [
{
"code": "261Q00000X",
"taxonomy_group": "",
"desc": "Clinic/Center",
"state": "NU",
"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 May 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.