Active NPI
Johanna Laros
- Specialist
- Jamaica, NY
National Provider Identifier
1912349358
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 158309827
- Practice address
- 117-21 Sutphin Boulevard
Jamaica, NY 11434 - Phone
- (718) 848-0276
- NPI assigned
- Jul 26, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 158309827 | NY | Primary |
Addresses
Primary practice location
117-21 Sutphin Boulevard
Jamaica, NY 11434
Mailing address
555 Franklin Blvd
Long Beach, NY 11561-2447
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1224220 | Other | NY | TEACH CERTIFICATE |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 158309827 | NY | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1374796800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1374796800000",
"number": "1912349358",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "555 FRANKLIN BLVD",
"city": "LONG BEACH",
"state": "NY",
"postal_code": "115612447"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "117-21 SUTPHIN BOULEVARD",
"city": "JAMAICA",
"state": "NY",
"postal_code": "11434",
"telephone_number": "718-848-0276"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAROS",
"first_name": "JOHANNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-07-26",
"last_updated": "2013-07-26",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "NY",
"license": "158309827",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TEACH CERTIFICATE",
"identifier": "1224220",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Jamaica, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.