Active NPI
Alan Siedlecki
- Allergy & Immunology Physician
- Valley Stream, NY
National Provider Identifier
1477549475
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Allergy & Immunology Physician
- License
- 216691
- Practice address
- 779 Golf Dr
Valley Stream, NY 11581 - Phone
- (516) 791-0145
- NPI assigned
- Sep 25, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Allergy & Immunology Physician | 207K00000X | 216691 | NY | Primary |
| Pediatrics Physician | 208000000X | 216691 | NY |
Addresses
Primary practice location
779 Golf Dr
Valley Stream, NY 11581
Mailing address
779 Golf Dr
Valley Stream, NY 11581
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127606400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1401235200000",
"number": "1477549475",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "779 GOLF DR",
"city": "VALLEY STREAM",
"state": "NY",
"postal_code": "11581"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "779 GOLF DR",
"city": "VALLEY STREAM",
"state": "NY",
"postal_code": "11581",
"telephone_number": "516-791-0145"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIEDLECKI",
"first_name": "ALAN",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-09-25",
"last_updated": "2014-05-28",
"status": "A"
},
"taxonomies": [
{
"code": "207K00000X",
"taxonomy_group": "",
"desc": "Allergy & Immunology",
"state": "NY",
"license": "216691",
"primary": true
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NY",
"license": "216691",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Valley Stream, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.