Individual provider Active NPI

Recaldia Tella, RN

  • Registered Nurse
  • Long Island City, NY
National Provider Identifier
1356009641
Registry record updated Jul 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
830882 Issued in NY
Practice address
2976 Northern Blvd FL 2
Long Island City, NY 11101-2829
Phone
(212) 691-7554
NPI assigned
Dec 3, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 24, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 830882 NY Primary

Addresses

Primary practice location

2976 Northern Blvd FL 2
Long Island City, NY 11101-2829

Mailing address

2976 Northern Blvd
Long Island City, NY 11101-2822
Phone (126) 917-5542

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
830882NYMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
The Fortune Society CurrentSince Jul 31, 2023 Accepting new patients
The Fortune Society Inc. CurrentSince Jul 31, 2023 Accepting new patients

Locations

2976 Northern Blvd
Fl 2
Long Island City, NY 11101
Phone (212) 691-7554

2976 Northern Blvd
Long Island City, NY 11101
Phone (212) 691-7554

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1638489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690156800000",
    "number": "1356009641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2976 NORTHERN BLVD",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111012822",
            "telephone_number": "126-917-5542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2976 NORTHERN BLVD FL 2",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111012829",
            "telephone_number": "212-691-7554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TELLA",
        "first_name": "RECALDIA",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-12-03",
        "last_updated": "2023-07-24",
        "certification_date": "2023-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "830882",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Island City, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2023; 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.