189-04 Facility Inc

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

Legal business name

189-04 FACILITY INC

Practice address

18904 Union Tpke
Suite B
Fresh Meadows, NY 11366-1862

Phone

(718) 271-1414

NPI assigned

Dec 21, 2014

Last updated

Dec 21, 2014By 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

Dr. Allen Antonelli, M.D.

Title

President

Phone

(718) 217-1414

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1419120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1419120000000",
    "number": "1538567730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18904 UNION TPKE",
            "address_2": "SUITE B",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113661862",
            "telephone_number": "718-271-1414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18904 UNION TPKE",
            "address_2": "SUITE B",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113661862",
            "telephone_number": "718-271-1414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "189-04 FACILITY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-21",
        "last_updated": "2014-12-21",
        "status": "A",
        "authorized_official_last_name": "ANTONELLI",
        "authorized_official_first_name": "ALLEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-217-1414",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "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 Dec 21, 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.

Verify at the official NPI Registry.