Individual provider Active NPI

Amado Leonardo Estrada Fernandez, MEDICAL DOCTOR

  • Student in an Organized Health Care Education/Training Program
  • Bronx, NY
National Provider Identifier
1760236384
Registry record updated Apr 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
234 E 149TH St RM 445a
Bronx, NY 10451-5504
Phone
(718) 579-6011
NPI assigned
Apr 11, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NY Primary

Addresses

Primary practice location

234 E 149TH St RM 445a
Bronx, NY 10451-5504

Mailing address

234 E 149TH St RM 445a
Bronx, NY 10451-5504
Phone (718) 579-6011

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": "1712793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712793600000",
    "number": "1760236384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "234 E 149TH ST RM 445A",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104515504",
            "telephone_number": "718-579-6011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "234 E 149TH ST RM 445A",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104515504",
            "telephone_number": "718-579-6011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESTRADA FERNANDEZ",
        "first_name": "AMADO",
        "middle_name": "LEONARDO",
        "name_prefix": "Dr.",
        "credential": "MEDICAL DOCTOR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-04-11",
        "last_updated": "2024-04-11",
        "certification_date": "2024-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2024; 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.