Individual provider Active NPI

Christopher Nigel Lake, M.S. ED

  • Specialist
  • Rego Park, NY
National Provider Identifier
1538579255
Registry record updated Apr 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Practice address
9310 Queens Blvd Apt 4E
Rego Park, NY 11374-1103
Phone
(140) 151-6719
NPI assigned
May 2, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 3, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X
Specialist 174400000X Primary

Addresses

Primary practice location

9310 Queens Blvd Apt 4E
Rego Park, NY 11374-1103

Mailing address

9310 Queens Blvd
4E
Rego Park, NY 11374-1146
Phone (401) 516-7192

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
Credentials
Master of Science

NPI Registry JSON

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

{
    "created_epoch": "1398988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585872000000",
    "number": "1538579255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9310 QUEENS BLVD",
            "address_2": "4E",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113741146",
            "telephone_number": "401-516-7192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9310 QUEENS BLVD APT 4E",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113741103",
            "telephone_number": "140-151-6719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAKE",
        "first_name": "CHRISTOPHER",
        "middle_name": "NIGEL",
        "credential": "M.S. ED",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-05-02",
        "last_updated": "2020-04-03",
        "certification_date": "2020-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rego Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2020; 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.