Active NPI
Evelyne Dorival
- Addiction Medicine (Psychiatry & Neurology) Physician
- Bellerose, NY
National Provider Identifier
1790140689
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction Medicine (Psychiatry & Neurology) Physician
- License
- 4203191
- Practice address
- 7403 Commonwealth Blvd
Bellerose, NY 11426-1839 - Phone
- (718) 264-4500
- Fax
- (718) 264-4933
- NPI assigned
- Dec 21, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction Medicine (Psychiatry & Neurology) Physician | 2084A0401X | 4203191 | NY | Primary |
Addresses
Primary practice location
7403 Commonwealth Blvd
Bellerose, NY 11426-1839
Mailing address
7403 Commonwealth Blvd
Bellerose, NY 11426-1839
Phone (718) 264-4500
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
| License | State | Type | Specialty |
|---|---|---|---|
| 4203191 | NY | MD | Addiction Medicine (Psychiatry & Neurology) Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1450656000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1450656000000",
"number": "1790140689",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7403 COMMONWEALTH BLVD",
"city": "BELLEROSE",
"state": "NY",
"postal_code": "114261839",
"telephone_number": "718-264-4500",
"fax_number": "718-264-4933"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7403 COMMONWEALTH BLVD",
"city": "BELLEROSE",
"state": "NY",
"postal_code": "114261839",
"telephone_number": "718-264-4500",
"fax_number": "718-264-4933"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DORIVAL",
"first_name": "EVELYNE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-12-21",
"last_updated": "2015-12-21",
"status": "A"
},
"taxonomies": [
{
"code": "2084A0401X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Addiction Medicine",
"state": "NY",
"license": "4203191",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bellerose, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 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.