NPIMap

Organization Active NPI

Cda Medical

Doing business as CDA Medical-Passport Health

  • Public Health & General Preventive Medicine Physician
  • Queens, NY
National Provider Identifier
1740981372
Registry record updated Mar 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health & General Preventive Medicine PhysicianTaxonomy code 2083P0901X
Legal business name
CDA MEDICAL
Doing business as
CDA Medical-Passport Health
Practice address
104-70 Queens Blvd
Ste 314
Queens, NY 11375
Phone
(877) 358-8648
Fax
(877) 877-6875
NPI assigned
Mar 10, 2023
Last updated
Mar 10, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2023

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

Authorized official

Name
Victoria Sowards, BSN, RN
Title
Director Clinical Compliance
Phone
(480) 646-9028

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health & General Preventive Medicine Physician 2083P0901X Primary

Addresses

Primary practice location

104-70 Queens Blvd
Ste 314
Queens, NY 11375

Mailing address

668 N 44 Street
Ste 210W
Phoenix, AZ 85008
Phone (480) 646-9028

Other names 1

  • CDA Medical-Passport Health Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Cda Medical PLLC14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

Organizations that report the same tax identification number in the National Provider Directory.

View all 13

Locations

10470 Queens Blvd
Ste 314
Forest Hills, NY 11375

NPI Registry JSON

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

{
    "created_epoch": "1678406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678406400000",
    "number": "1740981372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "668 N 44 STREET",
            "address_2": "STE 210W",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85008",
            "telephone_number": "480-646-9028",
            "fax_number": "877-877-6875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104-70 QUEENS BLVD",
            "address_2": "STE 314",
            "city": "QUEENS",
            "state": "NY",
            "postal_code": "11375",
            "telephone_number": "877-358-8648",
            "fax_number": "877-877-6875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CDA MEDICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-10",
        "last_updated": "2023-03-10",
        "certification_date": "2023-03-10",
        "status": "A",
        "authorized_official_last_name": "SOWARDS",
        "authorized_official_first_name": "VICTORIA",
        "authorized_official_title_or_position": "DIRECTOR CLINICAL COMPLIANCE",
        "authorized_official_telephone_number": "480-646-9028",
        "authorized_official_credential": "BSN, RN"
    },
    "taxonomies": [
        {
            "code": "2083P0901X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CDA Medical-Passport Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Queens, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2023; 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.