Active NPI
Dominique Alicia Preville
- Registered Nurse
- Queens, NY
National Provider Identifier
1548885528
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 778070
- Practice address
- 127-14 122ND Street
Apt 2
Queens, NY 11434 - Phone
- (347) 430-6758
- NPI assigned
- Jun 15, 2020
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 778070 | NY | Primary |
Addresses
Primary practice location
127-14 122ND Street
Apt 2
Queens, NY 11434
Mailing address
127-14 122ND Street
Apt 2
Queens, NY 11434
Phone (347) 430-6758
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 |
|---|---|---|---|
| 778070 | NY | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1592179200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1592179200000",
"number": "1548885528",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "127-14 122ND STREET",
"address_2": "APT 2",
"city": "QUEENS",
"state": "NY",
"postal_code": "11434",
"telephone_number": "347-430-6758"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "127-14 122ND STREET",
"address_2": "APT 2",
"city": "QUEENS",
"state": "NY",
"postal_code": "11434",
"telephone_number": "347-430-6758"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PREVILLE",
"first_name": "DOMINIQUE",
"middle_name": "ALICIA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-06-15",
"last_updated": "2020-06-15",
"certification_date": "2020-06-15",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NY",
"license": "778070",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Queens, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 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.