Individual provider Active NPI

Daniel Tomback

  • Local Education Agency (LEA)
  • Forest Hills, NY
National Provider Identifier
1730672312
Registry record updated Jun 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Local Education Agency (LEA)Taxonomy code 251300000X
Practice address
6771 Yellowstone Blvd Apt 2U
Forest Hills, NY 11375-2853
Phone
(917) 500-2310
NPI assigned
Jun 8, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 8, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Local Education Agency (LEA) 251300000X Primary

Addresses

Primary practice location

6771 Yellowstone Blvd Apt 2U
Forest Hills, NY 11375-2853

Mailing address

6771 Yellowstone Blvd Apt 2U
Forest Hills, NY 11375-2853
Phone (917) 500-2310

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

NPI Registry JSON

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

{
    "created_epoch": "1528416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528416000000",
    "number": "1730672312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6771 YELLOWSTONE BLVD APT 2U",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113752853",
            "telephone_number": "917-500-2310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6771 YELLOWSTONE BLVD APT 2U",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113752853",
            "telephone_number": "917-500-2310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOMBACK",
        "first_name": "DANIEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-06-08",
        "last_updated": "2018-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251300000X",
            "taxonomy_group": "",
            "desc": "Local Education Agency (LEA)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hills, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2018; 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.