Individual provider Active NPI

Saly Tomi Madathil

  • Child & Adolescent Psychiatric/Mental Health Registered Nurse
  • Bellerose, NY
National Provider Identifier
1417591553
Registry record updated Nov 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0807X
License
45513 Issued in NY
Practice address
7403 Commonwealth Blvd
Bellerose, NY 11426-1839
Phone
(718) 264-4500
NPI assigned
Nov 1, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatric/Mental Health Registered Nurse 163WP0807X 45513 NY Primary

Addresses

Primary practice location

7403 Commonwealth Blvd
Bellerose, NY 11426-1839

Mailing address

7403 Commonwealth Blvd
Bellerose, NY 11426-1839
Phone (718) 264-4500

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

State licenses

LicenseStateTypeSpecialty
45513NYMDChild & Adolescent Psychiatric/Mental Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1572566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572566400000",
    "number": "1417591553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7403 COMMONWEALTH BLVD",
            "city": "BELLEROSE",
            "state": "NY",
            "postal_code": "114261839",
            "telephone_number": "718-264-4500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7403 COMMONWEALTH BLVD",
            "city": "BELLEROSE",
            "state": "NY",
            "postal_code": "114261839",
            "telephone_number": "718-264-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADATHIL",
        "first_name": "SALY",
        "middle_name": "TOMI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-01",
        "last_updated": "2019-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0807X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Child & Adolescent",
            "state": "NY",
            "license": "45513",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellerose, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 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.