Active NPI
Gabriel Koyenov, LMFT
- Marriage & Family Therapist
- Flushing, NY
National Provider Identifier
1508636606
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 002225
- Practice address
- 14439 76TH Ave
Flushing, NY 11367-3115 - Phone
- (646) 662-0617
- NPI assigned
- Jan 9, 2024
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 002225 | NY | Primary |
Addresses
Primary practice location
14439 76TH Ave
Flushing, NY 11367-3115
Mailing address
14439 76TH Ave
Flushing, NY 11367-3115
Phone (646) 662-0617
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
| License | State | Type | Specialty |
|---|---|---|---|
| 002225 | NY | MD | Podiatrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1704758400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1704758400000",
"number": "1508636606",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14439 76TH AVE",
"city": "FLUSHING",
"state": "NY",
"postal_code": "113673115",
"telephone_number": "646-662-0617"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14439 76TH AVE",
"city": "FLUSHING",
"state": "NY",
"postal_code": "113673115",
"telephone_number": "646-662-0617"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOYENOV",
"first_name": "GABRIEL",
"credential": "LMFT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-01-09",
"last_updated": "2024-01-09",
"certification_date": "2024-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "NY",
"license": "002225",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Flushing, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.