NP in Adult Health Diagnostic and Treatment, PLLC

Primary specialty

General Practice Registered NurseTaxonomy code 163WG0000X

License

304254 Issued in NY

Legal business name

NP IN ADULT HEALTH DIAGNOSTIC AND TREATMENT, PLLC

Practice address

8708 Justice Ave
2E
Elmhurst, NY 11373-4575

Phone

(718) 554-1150

NPI assigned

Jul 19, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Alexander E Istomin MD, MD, MS, MS

Title

Medical Administrator

Phone

(718) 554-1150

Specialties & licenses 7

Addresses

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

{
    "created_epoch": "1342656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433808000000",
    "number": "1750636221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8708 JUSTICE AVE",
            "address_2": "2E",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113734575",
            "telephone_number": "718-554-1150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8708 JUSTICE AVE",
            "address_2": "2E",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113734575",
            "telephone_number": "718-554-1150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NP IN ADULT HEALTH DIAGNOSTIC AND TREATMENT, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-19",
        "last_updated": "2015-06-09",
        "status": "A",
        "authorized_official_last_name": "ISTOMIN MD",
        "authorized_official_first_name": "ALEXANDER",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "MEDICAL ADMINISTRATOR",
        "authorized_official_telephone_number": "718-554-1150",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD, MS, MS"
    },
    "taxonomies": [
        {
            "code": "146N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medical Technician, Basic",
            "state": "NY",
            "license": "304254",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "533201",
            "primary": false
        },
        {
            "code": "163WD0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": "NY",
            "license": "304254",
            "primary": false
        },
        {
            "code": "163WG0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, General Practice",
            "state": "NY",
            "license": "304254",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": "ZZ",
            "license": "242862",
            "primary": false
        },
        {
            "code": "2083P0901X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "ZZ",
            "license": "242862",
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NY",
            "license": "33D1092118",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2015; 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.