New York Diabetes Care, RN, PLLC

Primary specialty

SpecialistTaxonomy code 174400000X

License

157094 Issued in NY

Legal business name

NEW YORK DIABETES CARE, RN, PLLC

Practice address

4 Bogardus PL
New York, NY 10040-2324

Phone

(917) 213-7184

Fax

(631) 206-9193

NPI assigned

Jul 6, 2011

Last updated

Jul 14, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Cassandra Henderson, M.D.

Title

Cfo

Phone

(917) 620-5230

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1309910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1310601600000",
    "number": "1851688246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2604 3RD AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104541199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 BOGARDUS PL",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100402324",
            "telephone_number": "917-213-7184",
            "fax_number": "631-206-9193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW YORK DIABETES CARE, RN, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-06",
        "last_updated": "2011-07-14",
        "status": "A",
        "authorized_official_last_name": "HENDERSON",
        "authorized_official_first_name": "CASSANDRA",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "917-620-5230",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "157094",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in New York, NY
• Providers in New York, NY by specialty
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2011; 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.