Individual provider Active NPI

Shelley Zomberg

  • Specialist
  • Monsey, NY
National Provider Identifier
1578011201
Registry record updated Sep 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
481406041 Issued in NY
Practice address
3 Lynhaven CT
Monsey, NY 10952-2411
Phone
(845) 578-5788
NPI assigned
Sep 11, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 481406041 NY Primary

Addresses

Primary practice location

3 Lynhaven CT
Monsey, NY 10952-2411

Mailing address

3 Lynhaven CT
Monsey, NY 10952-2411
Phone (845) 578-5788

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

LicenseStateTypeSpecialty
481406041NYMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1473552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473552000000",
    "number": "1578011201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 LYNHAVEN CT",
            "city": "MONSEY",
            "state": "NY",
            "postal_code": "109522411",
            "telephone_number": "845-578-5788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 LYNHAVEN CT",
            "city": "MONSEY",
            "state": "NY",
            "postal_code": "109522411",
            "telephone_number": "845-578-5788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZOMBERG",
        "first_name": "SHELLEY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-11",
        "last_updated": "2016-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "481406041",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monsey, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2016; 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.