Individual provider Active NPI

Collette S Bent

  • Research Study Specialist
  • Queens Village, NY
National Provider Identifier
1801402599
Registry record updated Sep 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Research Study SpecialistTaxonomy code 1744R1102X
License
1392257201 Issued in NY
Practice address
11226 208TH St
Queens Village, NY 11429-2206
Phone
(718) 776-3358
NPI assigned
Sep 18, 2020
Last updated
Sep 18, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 18, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Research Study Specialist 1744R1102X 1392257201 NY Primary

Addresses

Primary practice location

11226 208TH St
Queens Village, NY 11429-2206

Mailing address

11226 208TH St
Queens Village, NY 11429-2206
Phone (718) 776-3358

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
1392257201NYMDResearch Study Specialist

NPI Registry JSON

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

{
    "created_epoch": "1600387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600387200000",
    "number": "1801402599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11226 208TH ST",
            "city": "QUEENS VILLAGE",
            "state": "NY",
            "postal_code": "114292206",
            "telephone_number": "718-776-3358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11226 208TH ST",
            "city": "QUEENS VILLAGE",
            "state": "NY",
            "postal_code": "114292206",
            "telephone_number": "718-776-3358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENT",
        "first_name": "COLLETTE",
        "middle_name": "S",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-18",
        "last_updated": "2020-09-18",
        "certification_date": "2020-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1744R1102X",
            "taxonomy_group": "",
            "desc": "Specialist, Research Study",
            "state": "NY",
            "license": "1392257201",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Sep 18, 2020; 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.