Individual provider Active NPI

Leonid Podolyak, REGISTERED NURSE

  • Registered Nurse
  • New York, NY
National Provider Identifier
1730637323
Registry record updated Sep 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
478881-1 Issued in NY
Practice address
1540 York Ave Apt 9S
New York, NY 10028-5964
Phone
(212) 439-6253
NPI assigned
Sep 13, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 478881-1 NY Primary

Addresses

Primary practice location

1540 York Ave Apt 9S
New York, NY 10028-5964

Mailing address

1540 York Ave Apt 9S
New York, NY 10028-5964
Phone (212) 439-6253

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

LicenseStateTypeSpecialty
478881-1NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1473724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473724800000",
    "number": "1730637323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1540 YORK AVE APT 9S",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100285964",
            "telephone_number": "212-439-6253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1540 YORK AVE APT 9S",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100285964",
            "telephone_number": "212-439-6253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PODOLYAK",
        "first_name": "LEONID",
        "credential": "REGISTERED NURSE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-09-13",
        "last_updated": "2016-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "478881-1",
            "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 Sep 13, 2016; 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.