Active NPI
Tadisha Novalin Reid
- Registered Nurse
- Laurelton, NY
National Provider Identifier
1730487521
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 627987-1
- Practice address
- 134-30 231 Street
2ND FL
Laurelton, NY 11413 - Phone
- (347) 351-0969
- Fax
- (718) 527-2340
- NPI assigned
- Mar 3, 2011
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 627987-1 | NY | Primary |
Addresses
Primary practice location
134-30 231 Street
2ND FL
Laurelton, NY 11413
Mailing address
134-30 231 Street
2ND FL
Laurelton, NY 11413
Phone (347) 351-0969
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 |
|---|---|---|---|
| 627987-1 | NY | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1299110400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1299628800000",
"number": "1730487521",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "134-30 231 STREET",
"address_2": "2ND FL",
"city": "LAURELTON",
"state": "NY",
"postal_code": "11413",
"telephone_number": "347-351-0969",
"fax_number": "718-527-2340"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "134-30 231 STREET",
"address_2": "2ND FL",
"city": "LAURELTON",
"state": "NY",
"postal_code": "11413",
"telephone_number": "347-351-0969",
"fax_number": "718-527-2340"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REID",
"first_name": "TADISHA",
"middle_name": "NOVALIN",
"name_prefix": "Ms.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-03-03",
"last_updated": "2011-03-09",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NY",
"license": "627987-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Laurelton, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.