Individual provider Active NPI

Crismely Elizabeth Hernandez

  • Specialist
  • New York, NY
National Provider Identifier
1689925596
Registry record updated Oct 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Practice address
1787 Madison Ave
New York, NY 10035-4518
Phone
(212) 289-6100
NPI assigned
Oct 2, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 2, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X NY Primary

Addresses

Primary practice location

1787 Madison Ave
New York, NY 10035-4518

Mailing address

10215 Astoria Blvd
East Elmhurst, NY 11369-2006
Phone (917) 207-6356

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": "1349136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349136000000",
    "number": "1689925596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10215 ASTORIA BLVD",
            "city": "EAST ELMHURST",
            "state": "NY",
            "postal_code": "113692006",
            "telephone_number": "917-207-6356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1787 MADISON AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100354518",
            "telephone_number": "212-289-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "CRISMELY",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-02",
        "last_updated": "2012-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 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.