Quality Obs Alliance Ipa LLC

Primary specialty

Exclusive Provider OrganizationTaxonomy code 302F00000X

Legal business name

QUALITY OBS ALLIANCE IPA LLC

Practice address

992 S 2ND St
Ronkonkoma, NY 11779-7204

Phone

(516) 807-9324

NPI assigned

Nov 18, 2015

Organization subpart

No

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

Authorized official

Name

Andrew Winakor

Title

Member

Phone

(516) 807-9324

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1447804800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447804800000",
    "number": "1902270689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "992 S 2ND ST",
            "city": "RONKONKOMA",
            "state": "NY",
            "postal_code": "117797204",
            "telephone_number": "516-807-9324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "992 S 2ND ST",
            "city": "RONKONKOMA",
            "state": "NY",
            "postal_code": "117797204",
            "telephone_number": "516-807-9324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUALITY OBS ALLIANCE IPA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-18",
        "last_updated": "2015-11-18",
        "status": "A",
        "authorized_official_last_name": "WINAKOR",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "516-807-9324"
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Exclusive Provider Organization in Ronkonkoma, NY
• Providers in Ronkonkoma, NY by specialty
• Exclusive Provider Organization in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2015; 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.