Individual provider Active NPI

Nelli Kondratyuk, RN

  • Registered Nurse
  • Brooklyn, NY
National Provider Identifier
1811257959
Registry record updated May 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
636236 Issued in NY
Practice address
1338 E 69TH St
Brooklyn, NY 11234-5703
Phone
(718) 251-1231
Fax
(347) 702-7243
NPI assigned
May 23, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 636236 NY Primary

Addresses

Primary practice location

1338 E 69TH St
Brooklyn, NY 11234-5703

Mailing address

3699 Shore Pkwy
Brooklyn, NY 11235-1649
Phone (347) 702-4740

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
636236NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1337731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337731200000",
    "number": "1811257959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3699 SHORE PKWY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112351649",
            "telephone_number": "347-702-4740",
            "fax_number": "347-702-7243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1338 E 69TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112345703",
            "telephone_number": "718-251-1231",
            "fax_number": "347-702-7243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONDRATYUK",
        "first_name": "NELLI",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-23",
        "last_updated": "2012-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "636236",
            "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 May 23, 2012; 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.