Individual provider Active NPI

Kristin Antoinette Uvaydov, RN

  • Registered Nurse
  • Massapequa Park, NY
National Provider Identifier
1912329848
Registry record updated Jan 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
669215 Issued in NY
Practice address
144 Harbor LN
Massapequa Park, NY 11762-4006
Phone
(516) 732-4333
NPI assigned
Jan 12, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 12, 2014

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 669215 NY Primary

Addresses

Primary practice location

144 Harbor LN
Massapequa Park, NY 11762-4006

Mailing address

144 Harbor LN
Massapequa Park, NY 11762-4006
Phone (516) 732-4333

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
669215NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1389484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389484800000",
    "number": "1912329848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "144 HARBOR LN",
            "city": "MASSAPEQUA PARK",
            "state": "NY",
            "postal_code": "117624006",
            "telephone_number": "516-732-4333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "144 HARBOR LN",
            "city": "MASSAPEQUA PARK",
            "state": "NY",
            "postal_code": "117624006",
            "telephone_number": "516-732-4333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UVAYDOV",
        "first_name": "KRISTIN",
        "middle_name": "ANTOINETTE",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-01-12",
        "last_updated": "2014-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "669215",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Massapequa Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 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.