Organization Active NPI

Triune OB/GYN Services, LLC

  • Specialist
  • Brooklyn, NY
National Provider Identifier
1700896875
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
195127 Issued in NY
Legal business name
TRIUNE OB/GYN SERVICES, LLC
Practice address
1416 Beverley Rd
Brooklyn, NY 11226-4514
Phone
(718) 469-3377
NPI assigned
Aug 9, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Jacqueline Ford
Title
Sole Proprieter
Phone
(718) 469-3377

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 195127 NY Primary

Addresses

Primary practice location

1416 Beverley Rd
Brooklyn, NY 11226-4514

Mailing address

975 Jerome St
Baldwin, NY 11510-5018

Other identifiers 1

IdentifierTypeStateIssuer
01642204MedicaidNY

National Provider Directory

National Provider Directory

Locations

1416 Beverley Rd
Brooklyn, NY 11226
Phone (718) 469-0033

Practitioners & affiliated clinicians

Practitioners 3

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": "1155081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1700896875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "975 JEROME ST",
            "city": "BALDWIN",
            "state": "NY",
            "postal_code": "115105018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1416 BEVERLEY RD",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112264514",
            "telephone_number": "718-469-3377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRIUNE OB/GYN SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FORD",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_title_or_position": "SOLE PROPRIETER",
        "authorized_official_telephone_number": "718-469-3377"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NY",
            "license": "195127",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01642204",
            "state": "NY"
        }
    ],
    "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 Aug 22, 2020; 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.