Individual Provider

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

INDIVIDUAL PROVIDER

Practice address

3031 Brighton 1St St
Brooklyn, NY 11235-8017

Phone

(917) 612-5231

NPI assigned

Jan 30, 2013

Organization subpart

No

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

Authorized official

Name

Ms. Larisa Mishina

Title

Special Ed. Teacher

Phone

(917) 612-5231

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1359504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1359763200000",
    "number": "1538407259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3031 BRIGHTON 1ST ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112358017",
            "telephone_number": "917-612-5231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3031 BRIGHTON 1ST ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112358017",
            "telephone_number": "917-612-5231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIVIDUAL PROVIDER",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-30",
        "last_updated": "2013-02-02",
        "status": "A",
        "authorized_official_last_name": "MISHINA",
        "authorized_official_first_name": "LARISA",
        "authorized_official_title_or_position": "SPECIAL ED. TEACHER",
        "authorized_official_telephone_number": "917-612-5231",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2013; 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.