NPIMap

Organization Active NPI

I.E.S. Medical, PC

  • Physical Medicine & Rehabilitation Physician
  • Astoria, NY
National Provider Identifier
1699795963
Registry record updated Apr 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
155050 Issued in NY
Legal business name
I.E.S. MEDICAL, PC
Practice address
3804 31St Ave
Astoria, NY 11103-3800
Phone
(914) 328-8077
Fax
(914) 328-6083
NPI assigned
Jul 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2008

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

Authorized official

Name
Cornelia Krieger
Title
Provder Coordinator
Phone
(914) 328-8077

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208100000X 155050 NY Primary

Addresses

Primary practice location

3804 31St Ave
Astoria, NY 11103-3800

Mailing address

174 Grand St
White Plains, NY 10601-4803
Phone (914) 328-8077

Other identifiers 1

IdentifierTypeStateIssuer
04527OtherNYGHI MEDICARE

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208908800000",
    "number": "1699795963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "174 GRAND ST",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106014803",
            "telephone_number": "914-328-8077",
            "fax_number": "914-328-6083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3804 31ST AVE",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111033800",
            "telephone_number": "914-328-8077",
            "fax_number": "914-328-6083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "I.E.S. MEDICAL, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-20",
        "last_updated": "2008-04-23",
        "status": "A",
        "authorized_official_last_name": "KRIEGER",
        "authorized_official_first_name": "CORNELIA",
        "authorized_official_title_or_position": "PROVDER COORDINATOR",
        "authorized_official_telephone_number": "914-328-8077"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NY",
            "license": "155050",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI MEDICARE",
            "identifier": "04527",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Astoria, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2008; 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.