Active NPI
Angelique Anderson, M.D.
- Legal Medicine
- New York, NY
National Provider Identifier
1437284130
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Legal Medicine
- License
- 216903
- Practice address
- 4290 Broadway
Suite 2S
New York, NY 10033-3732 - Phone
- (212) 781-5075
- Fax
- (212) 781-5329
- NPI assigned
- Feb 22, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Legal Medicine | 173000000X | 216903 | NY | Primary |
Addresses
Primary practice location
4290 Broadway
Suite 2S
New York, NY 10033-3732
Mailing address
33 W 127TH St
#1G
New York, NY 10027-3830
Phone (917) 312-3381
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 216903 | NY | MD | Legal Medicine |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University Care LLC | Past | Accepting new patients | |
| University Care | Past | Accepting new patients |
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.
-
- Health Service Psychologist
- Baltimore, MD
- NPI 1629210166
-
- Family Medicine Physician
- Baltimore, MD
- NPI 1497760276
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172102400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1428883200000",
"number": "1437284130",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "33 W 127TH ST",
"address_2": "#1G",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100273830",
"telephone_number": "917-312-3381"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4290 BROADWAY",
"address_2": "SUITE 2S",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100333732",
"telephone_number": "212-781-5075",
"fax_number": "212-781-5329"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "ANGELIQUE",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-22",
"last_updated": "2015-04-13",
"status": "A"
},
"taxonomies": [
{
"code": "173000000X",
"taxonomy_group": "",
"desc": "Legal Medicine",
"state": "NY",
"license": "216903",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.