Organization Active NPI

Louis Dalaveris, M.D., P.C.

  • Ophthalmology Physician
  • New York, NY
National Provider Identifier
1457638843
Registry record updated Nov 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
NY145813 Issued in NY
Legal business name
LOUIS DALAVERIS, M.D., P.C.
Practice address
30 W 60TH St
Suite 1Y
New York, NY 10023-7902
Phone
(212) 245-0203
Fax
(212) 245-0372
NPI assigned
Nov 14, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2011

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

Authorized official

Name
Dr. Louis Dalaveris, M.D.
Title
President
Phone
(212) 245-0203

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X NY145813 NY Primary

Addresses

Primary practice location

30 W 60TH St
Suite 1Y
New York, NY 10023-7902

Mailing address

30 W 60TH St
Suite 1Y
New York, NY 10023-7902
Phone (212) 245-0203

Other identifiers 1

IdentifierTypeStateIssuer
00758030MedicaidNY

National Provider Directory

National Provider Directory

Locations

2747 Crescent St
Ste 203
Astoria, NY 11102
Phone (347) 869-9798

NPI Registry JSON

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

{
    "created_epoch": "1321228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1321228800000",
    "number": "1457638843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 W 60TH ST",
            "address_2": "SUITE 1Y",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100237902",
            "telephone_number": "212-245-0203",
            "fax_number": "212-245-0372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 W 60TH ST",
            "address_2": "SUITE 1Y",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100237902",
            "telephone_number": "212-245-0203",
            "fax_number": "212-245-0372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOUIS DALAVERIS, M.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-14",
        "last_updated": "2011-11-14",
        "status": "A",
        "authorized_official_last_name": "DALAVERIS",
        "authorized_official_first_name": "LOUIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "212-245-0203",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "NY",
            "license": "NY145813",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00758030",
            "state": "NY"
        }
    ],
    "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 Nov 14, 2011; 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.