Individual provider Active NPI

Ilana Beth Dubin

  • Specialist
  • Woodmere, NY
National Provider Identifier
1467704387
Registry record updated Oct 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
1851947 Issued in NY
Practice address
588 Barnard Ave
Woodmere, NY 11598-2710
Phone
(516) 792-1407
NPI assigned
Oct 3, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 3, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 1851947 NY Primary

Addresses

Primary practice location

588 Barnard Ave
Woodmere, NY 11598-2710

Mailing address

588 Barnard Ave
Woodmere, NY 11598-2710
Phone (516) 792-1407

Other identifiers 1

IdentifierTypeStateIssuer
1851947OtherNYCERTIFICATION

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
1851947NYMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1349222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349222400000",
    "number": "1467704387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "588 BARNARD AVE",
            "city": "WOODMERE",
            "state": "NY",
            "postal_code": "115982710",
            "telephone_number": "516-792-1407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "588 BARNARD AVE",
            "city": "WOODMERE",
            "state": "NY",
            "postal_code": "115982710",
            "telephone_number": "516-792-1407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUBIN",
        "first_name": "ILANA",
        "middle_name": "BETH",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-03",
        "last_updated": "2012-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "1851947",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CERTIFICATION",
            "identifier": "1851947",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodmere, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2012; 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.