Tristate Ny Diagnostics Inc

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

TRISTATE NY DIAGNOSTICS INC

Practice address

2464 Coney Island Ave
3 Floor
Brooklyn, NY 11223-5022

Phone

(718) 336-2753

Fax

(718) 339-0170

NPI assigned

Aug 9, 2016

Last updated

Aug 9, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ramaz Mitaishvili

Title

President

Phone

(718) 336-2753

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1470700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470700800000",
    "number": "1518411412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2464 CONEY ISLAND AVE",
            "address_2": "3 FLOOR",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112235022",
            "telephone_number": "718-336-2753",
            "fax_number": "718-339-0170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2464 CONEY ISLAND AVE",
            "address_2": "3 FLOOR",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112235022",
            "telephone_number": "718-336-2753",
            "fax_number": "718-339-0170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRISTATE NY DIAGNOSTICS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-09",
        "last_updated": "2016-08-09",
        "status": "A",
        "authorized_official_last_name": "MITAISHVILI",
        "authorized_official_first_name": "RAMAZ",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-336-2753"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dawn Triplett
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• Specialist in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2016; 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.