Individual provider Active NPI

Chana Polishuk

  • Registered Nurse
  • Far Rockaway, NY
National Provider Identifier
1861765125
Registry record updated Feb 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
649689 Issued in NY
Practice address
802 Roosevelt St
Far Rockaway, NY 11691-5247
Phone
(516) 710-5642
NPI assigned
Feb 17, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 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 649689 NY Primary

Addresses

Primary practice location

802 Roosevelt St
Far Rockaway, NY 11691-5247

Mailing address

802 Roosevelt St
Far Rockaway, NY 11691-5247
Phone (516) 710-5642

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
649689NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1329436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329436800000",
    "number": "1861765125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "802 ROOSEVELT ST",
            "city": "FAR ROCKAWAY",
            "state": "NY",
            "postal_code": "116915247",
            "telephone_number": "516-710-5642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "802 ROOSEVELT ST",
            "city": "FAR ROCKAWAY",
            "state": "NY",
            "postal_code": "116915247",
            "telephone_number": "516-710-5642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLISHUK",
        "first_name": "CHANA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-17",
        "last_updated": "2012-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "649689",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Far Rockaway, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 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.