Avantage Diagnostic

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

587393326 Issued in NY

Legal business name

AVANTAGE DIAGNOSTIC

Practice address

734 Franklin Ave
Suite 183
Garden City, NY 11530-4525

Phone

(973) 747-9410

NPI assigned

Apr 16, 2014

Last updated

Apr 16, 2014By 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. Monique Pascual, DC

Title

Owner

Phone

(973) 747-9410

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1397606400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1397606400000",
    "number": "1881013910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "734 FRANKLIN AVE",
            "address_2": "SUITE 183",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115304525",
            "telephone_number": "973-747-9410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "734 FRANKLIN AVE",
            "address_2": "SUITE 183",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115304525",
            "telephone_number": "973-747-9410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVANTAGE DIAGNOSTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-16",
        "last_updated": "2014-04-16",
        "status": "A",
        "authorized_official_last_name": "PASCUAL",
        "authorized_official_first_name": "MONIQUE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "973-747-9410",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "587393326",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2014; 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.