Organization Active NPI

White Medical, PC

  • Physical Medicine & Rehabilitation Physician
  • Kew Gardens, NY
National Provider Identifier
1841210689
Registry record updated Mar 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
163661 Issued in NY
Legal business name
WHITE MEDICAL, PC
Practice address
11905 80TH Rd
Kew Gardens, NY 11415-1105
Phone
(718) 635-1210
Fax
(718) 663-7134
NPI assigned
Jul 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2013

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

Authorized official

Name
Dr. Robert Edmund White, M.D.
Title
President
Phone
(718) 635-1210

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208100000X 163661 NY Primary

Addresses

Primary practice location

11905 80TH Rd
Kew Gardens, NY 11415-1105

Mailing address

11905 80TH Rd
Kew Gardens, NY 11415-1105
Phone (718) 635-1210

Other identifiers 1

IdentifierTypeStateIssuer
07373AOtherNYMEDICARE ID

National Provider Directory

National Provider Directory

Locations

783 Hempstead Tpke
Franklin Square, NY 11010
Phone (516) 352-4655

6815 Myrtle Ave
Glendale, NY 11385
Phone (718) 417-1150

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1362096000000",
    "number": "1841210689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11905 80TH RD",
            "city": "KEW GARDENS",
            "state": "NY",
            "postal_code": "114151105",
            "telephone_number": "718-635-1210",
            "fax_number": "718-663-7134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11905 80TH RD",
            "city": "KEW GARDENS",
            "state": "NY",
            "postal_code": "114151105",
            "telephone_number": "718-635-1210",
            "fax_number": "718-663-7134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHITE MEDICAL, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-21",
        "last_updated": "2013-03-01",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "EDMUND",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-635-1210",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NY",
            "license": "163661",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "07373A",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kew Gardens, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2013; 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.