NPIMap

Organization Active NPI

Central Park Diagnostic, Inc.

  • Specialist
  • Rosedale, NY
National Provider Identifier
1881976272
Registry record updated Sep 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
245082 Issued in NY
Legal business name
CENTRAL PARK DIAGNOSTIC, INC.
Practice address
24111 147TH Ave
Rosedale
Rosedale, NY 11422-2455
Phone
(212) 974-0490
Fax
(212) 974-0493
NPI assigned
Sep 13, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2011

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

Authorized official

Name
Shahnoz Rustamova, M.D.NPI 1629112149
Title
Owner
Phone
(212) 974-0490

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 245082 NY Primary

Addresses

Primary practice location

24111 147TH Ave
Rosedale
Rosedale, NY 11422-2455

Mailing address

134 W 58TH St
Ste. 102
New York, NY 10019-2153
Phone (212) 974-0490

National Provider Directory

National Provider Directory
Tax ID family
Central Park Diagnostic Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1315872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1315872000000",
    "number": "1881976272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "134 W 58TH ST",
            "address_2": "STE. 102",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100192153",
            "telephone_number": "212-974-0490",
            "fax_number": "212-974-0493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24111 147TH AVE",
            "address_2": "ROSEDALE",
            "city": "ROSEDALE",
            "state": "NY",
            "postal_code": "114222455",
            "telephone_number": "212-974-0490",
            "fax_number": "212-974-0493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL PARK DIAGNOSTIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-13",
        "last_updated": "2011-09-13",
        "status": "A",
        "authorized_official_last_name": "RUSTAMOVA",
        "authorized_official_first_name": "SHAHNOZ",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "212-974-0490",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NY",
            "license": "245082",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rosedale, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 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.