Active NPI
Tahisha Stewart
- Early Intervention Provider Agency
- Brooklyn, NY
National Provider Identifier
1659011856
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Early Intervention Provider Agency
- License
- 2634480
- Practice address
- 1217 E 102ND St
Brooklyn, NY 11236-5034 - Phone
- (347) 418-6468
- NPI assigned
- Mar 29, 2022
- 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 |
|---|---|---|---|---|
| Early Intervention Provider Agency | 252Y00000X | 2634480 | NY | Primary |
Addresses
Primary practice location
1217 E 102ND St
Brooklyn, NY 11236-5034
Mailing address
1217 E 102ND St
Brooklyn, NY 11236-5034
Phone (347) 418-6468
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 |
|---|---|---|---|
| 2634480 | NY | MD | Early Intervention Provider Agency |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1648512000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1648512000000",
"number": "1659011856",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1217 E 102ND ST",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112365034",
"telephone_number": "347-418-6468"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1217 E 102ND ST",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112365034",
"telephone_number": "347-418-6468"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEWART",
"first_name": "TAHISHA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-03-29",
"last_updated": "2022-03-29",
"certification_date": "2022-03-29",
"status": "A"
},
"taxonomies": [
{
"code": "252Y00000X",
"taxonomy_group": "",
"desc": "Early Intervention Provider Agency",
"state": "NY",
"license": "2634480",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.