Active NPI
Aneta Predanic
- Psychiatry Physician
- Queens Village, NY
National Provider Identifier
1790800605
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 215747
- Practice address
- 8045 Winchester Blvd
Queens Village, NY 11427-2193 - Phone
- (718) 464-7500
- NPI assigned
- Mar 20, 2007
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 215747 | NY | Primary |
Addresses
Primary practice location
8045 Winchester Blvd
Queens Village, NY 11427-2193
Mailing address
7511 178TH St
Fresh Meadows, NY 11366-1627
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 215747 | Medicaid | NY |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 215747 | NY | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174348800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1790800605",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7511 178TH ST",
"city": "FRESH MEADOWS",
"state": "NY",
"postal_code": "113661627"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8045 WINCHESTER BLVD",
"city": "QUEENS VILLAGE",
"state": "NY",
"postal_code": "114272193",
"telephone_number": "718-464-7500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PREDANIC",
"first_name": "ANETA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "NY",
"license": "215747",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "215747",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Queens Village, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.