Wichuda Wichaidit McConnell

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

License

16703 Issued in NY

Practice address

1959 76TH St
2 Floor
East Elmhurst, NY 11370-8007

Phone

(347) 612-7390

Fax

(877) 501-1015

NPI assigned

Jun 18, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Miss Wichuda Wichaidit Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1339977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339977600000",
    "number": "1477816221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19-59 76TH ST",
            "address_2": "2 FLOOR",
            "city": "EAST ELMHURST",
            "state": "NY",
            "postal_code": "11370",
            "telephone_number": "347-612-7390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1959 76TH ST",
            "address_2": "2 FLOOR",
            "city": "EAST ELMHURST",
            "state": "NY",
            "postal_code": "113708007",
            "telephone_number": "347-612-7390",
            "fax_number": "877-501-1015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCONNELL",
        "first_name": "WICHUDA",
        "middle_name": "WICHAIDIT",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-18",
        "last_updated": "2012-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NY",
            "license": "16703",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "WICHUDA",
            "last_name": "WICHAIDIT",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Case Manager/Care Coordinator in East Elmhurst, NY
• Providers in East Elmhurst, NY by specialty
• Case Manager/Care Coordinator in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 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.