Ivymc,Inc

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

230713 Issued in NY

Legal business name

IVYMC,INC

Practice address

14022 Beech Ave
Flushing, NY 11355-2821

Phone

(201) 970-1337

NPI assigned

Aug 16, 2012

Last updated

Aug 16, 2012By 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

Wei Wei Niu, M.D.

Title

President

Phone

(201) 970-1337

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1345075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1345075200000",
    "number": "1598013955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "91 FRANKLIN ST",
            "city": "TENAFLY",
            "state": "NJ",
            "postal_code": "076702006",
            "telephone_number": "201-970-1337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14022 BEECH AVE",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113552821",
            "telephone_number": "201-970-1337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IVYMC,INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-16",
        "last_updated": "2012-08-16",
        "status": "A",
        "authorized_official_last_name": "NIU",
        "authorized_official_first_name": "WEI WEI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "201-970-1337",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "NY",
            "license": "230713",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Debra Itzkowitz, LMSW
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• General Practice Physician in Flushing, NY
• Providers in Flushing, NY by specialty
• General Practice Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2012; 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.