Active NPI
Jonathan Estrada, LAC
- Acupuncturist
- Ridgewood, NY
National Provider Identifier
1568774339
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- 004129
- Practice address
- 1633 Cornelia St
Lower Level
Ridgewood, NY 11385-4729 - Phone
- (347) 907-2968
- Fax
- (718) 821-5619
- NPI assigned
- Jul 9, 2010
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Acupuncturist | 171100000X | 004129 | NY | Primary |
Addresses
Primary practice location
1633 Cornelia St
Lower Level
Ridgewood, NY 11385-4729
Mailing address
1633 Cornelia Street
Lower Level
Ridgewood, NY 11385-4729
Phone (347) 907-2968
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 |
|---|---|---|---|
| 004129 | NY | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1278633600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1278633600000",
"number": "1568774339",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1633 CORNELIA STREET",
"address_2": "LOWER LEVEL",
"city": "RIDGEWOOD",
"state": "NY",
"postal_code": "113854729",
"telephone_number": "347-907-2968",
"fax_number": "718-821-5619"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1633 CORNELIA ST",
"address_2": "LOWER LEVEL",
"city": "RIDGEWOOD",
"state": "NY",
"postal_code": "113854729",
"telephone_number": "347-907-2968",
"fax_number": "718-821-5619"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ESTRADA",
"first_name": "JONATHAN",
"name_prefix": "Mr.",
"credential": "LAC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-07-09",
"last_updated": "2010-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "NY",
"license": "004129",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ridgewood, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.