Active NPI
Tatyana Vladova, MS SP. ED.
- Specialist
- Long Island City, NY
National Provider Identifier
1972865681
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 1319149
- Practice address
- 4615 Center Blvd
#907
Long Island City, NY 11109-5738 - Phone
- (646) 824-6716
- NPI assigned
- Jun 10, 2012
- 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 | 1319149 | NY | Primary |
Addresses
Primary practice location
4615 Center Blvd
#907
Long Island City, NY 11109-5738
Mailing address
4615 Center Blvd
#907
Long Island City, NY 11109-5738
Phone (646) 824-6716
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
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1319149 | NY | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1339286400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1339286400000",
"number": "1972865681",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4615 CENTER BLVD",
"address_2": "#907",
"city": "LONG ISLAND CITY",
"state": "NY",
"postal_code": "111095738",
"telephone_number": "646-824-6716"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4615 CENTER BLVD",
"address_2": "#907",
"city": "LONG ISLAND CITY",
"state": "NY",
"postal_code": "111095738",
"telephone_number": "646-824-6716"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VLADOVA",
"first_name": "TATYANA",
"name_prefix": "Mrs.",
"credential": "MS SP. ED.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-06-10",
"last_updated": "2012-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "NY",
"license": "1319149",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Long Island City, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.