Individual provider Active NPI

Lisa Hom

  • Contractor
  • Brooklyn, NY
National Provider Identifier
1801049283
Registry record updated Oct 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ContractorTaxonomy code 171W00000X
License
0095991 Issued in NY
Practice address
66 Montague St
Brooklyn, NY 11201-3342
Phone
(718) 596-4742
NPI assigned
Oct 29, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 29, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Contractor 171W00000X 0095991 NY Primary

Addresses

Primary practice location

66 Montague St
Brooklyn, NY 11201-3342

Mailing address

66 Montague St
Brooklyn, NY 11201-3342
Phone (718) 596-4742

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

LicenseStateTypeSpecialty
0095991NYMDContractor

NPI Registry JSON

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

{
    "created_epoch": "1225238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225238400000",
    "number": "1801049283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 MONTAGUE ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112013342",
            "telephone_number": "718-596-4742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "66 MONTAGUE ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112013342",
            "telephone_number": "718-596-4742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOM",
        "first_name": "LISA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-29",
        "last_updated": "2008-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "NY",
            "license": "0095991",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2008; 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.