Individual provider Active NPI

Alla S Grayfer

  • Specialist
  • Staten Island, NY
National Provider Identifier
1609410067
Registry record updated Oct 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Practice address
29 Elmtree Ave
Staten Island, NY 10306-5055
Phone
(917) 208-0698
NPI assigned
Oct 29, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X Primary

Addresses

Primary practice location

29 Elmtree Ave
Staten Island, NY 10306-5055

Mailing address

29 Elmtree Ave
Staten Island, NY 10306-5055
Phone (917) 208-0698

Other identifiers 2

IdentifierTypeStateIssuer
620083674OtherNYDRIVER LICENCE
368679031OtherNY17 OTHER SERVICE PROVIDERS

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

NPI Registry JSON

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

{
    "created_epoch": "1572307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572307200000",
    "number": "1609410067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 ELMTREE AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103065055",
            "telephone_number": "917-208-0698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 ELMTREE AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103065055",
            "telephone_number": "917-208-0698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAYFER",
        "first_name": "ALLA",
        "middle_name": "S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-29",
        "last_updated": "2019-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRIVER LICENCE",
            "identifier": "620083674",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "17 OTHER SERVICE PROVIDERS",
            "identifier": "368679031",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2019; 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.