Individual provider Active NPI

Neazan Audler

  • Licensed Practical Nurse
  • Brooklyn, NY
National Provider Identifier
1730771460
Registry record updated Feb 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
332602 Issued in NY
Practice address
307 Kingsboro 3Rd Walk
Brooklyn, NY 11233-3670
Phone
(718) 785-7438
NPI assigned
Feb 4, 2021
Last updated
Feb 4, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 332602 NY Primary

Addresses

Primary practice location

307 Kingsboro 3Rd Walk
Brooklyn, NY 11233-3670

Mailing address

307 Kingsboro 3Rd Walk
Brooklyn, NY 11233-3670

Other identifiers 1

IdentifierTypeStateIssuer
332602MedicaidNY

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
332602NYMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1612396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612396800000",
    "number": "1730771460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 KINGSBORO 3RD WALK",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112333670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 KINGSBORO 3RD WALK",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112333670",
            "telephone_number": "718-785-7438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AUDLER",
        "first_name": "NEAZAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-04",
        "last_updated": "2021-02-04",
        "certification_date": "2021-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "332602",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "332602",
            "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 Feb 4, 2021; 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.