NPIMap

Organization Active NPI

Morrisania Diagnostic and Treatment Center

  • Clinic/Center
  • New York, NY
National Provider Identifier
1730264151
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
144173 Issued in NY
Legal business name
MORRISANIA DIAGNOSTIC AND TREATMENT CENTER
Practice address
158 E 115TH St
New York, NY 10029-2031
Phone
(212) 360-5919
Fax
(212) 828-0858
NPI assigned
Oct 25, 2006
Last updated
Aug 22, 2020By the provider in NPPES
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
Nellie Boma, M.D.NPI 1679652366
Title
Medical Director
Phone
(718) 960-2793

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 144173 NY Primary

Addresses

Primary practice location

158 E 115TH St
New York, NY 10029-2031

Mailing address

158 E 115TH St
New York, NY 10029-2031
Phone (212) 360-5919

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1730264151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "158 E 115TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100292031",
            "telephone_number": "212-360-5919",
            "fax_number": "212-828-0858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "158 E 115TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100292031",
            "telephone_number": "212-360-5919",
            "fax_number": "212-828-0858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MORRISANIA DIAGNOSTIC AND TREATMENT CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BOMA",
        "authorized_official_first_name": "NELLIE",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "718-960-2793",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NY",
            "license": "144173",
            "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 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.