Individual provider Active NPI

Inez Yadgarov

  • Specialist
  • Plainview, NY
National Provider Identifier
1912670225
Registry record updated Aug 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
3092316 Issued in NY
Practice address
255 Executive Dr Ste Ll108
Plainview, NY 11803-1707
Phone
(516) 576-2040
NPI assigned
Aug 1, 2021
Last updated
Aug 1, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 3092316 NY Primary

Addresses

Primary practice location

255 Executive Dr Ste Ll108
Plainview, NY 11803-1707

Mailing address

14115 72ND Dr
Flushing, NY 11367-2312
Phone (347) 639-9779

Other practice location 1

2447 Eastchester Rd # 2
Bronx, NY 10469-5915
Phone (718) 882-2111

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

LicenseStateTypeSpecialty
3092316NYMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1627776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627776000000",
    "number": "1912670225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14115 72ND DR",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113672312",
            "telephone_number": "347-639-9779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 EXECUTIVE DR STE LL108",
            "city": "PLAINVIEW",
            "state": "NY",
            "postal_code": "118031707",
            "telephone_number": "516-576-2040"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2447 Eastchester Rd # 2",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104695915",
            "country_code": "US",
            "telephone_number": "718-882-2111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YADGAROV",
        "first_name": "INEZ",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-01",
        "last_updated": "2021-08-01",
        "certification_date": "2021-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "3092316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plainview, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2021; 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.