Individual provider Active NPI

Stephen Palumbo, REGISTERD NURSE

  • Registered Nurse
  • Queens, NY
National Provider Identifier
1972879492
Registry record updated Mar 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
487518 Issued in NY
Practice address
42-09 28TH St
Queens, NY 11101-4132
Phone
(718) 710-1829
Fax
(347) 396-4767
NPI assigned
Mar 29, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 29, 2012

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 487518 NY Primary

Addresses

Primary practice location

42-09 28TH St
Queens, NY 11101-4132

Mailing address

547-77TH St
Brooklyn, NY 11209-3307
Phone (718) 710-1829

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
487518NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1332979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332979200000",
    "number": "1972879492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "547-77TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112093307",
            "telephone_number": "718-710-1829",
            "fax_number": "347-396-4767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42-09 28TH ST",
            "city": "QUEENS",
            "state": "NY",
            "postal_code": "111014132",
            "telephone_number": "718-710-1829",
            "fax_number": "347-396-4767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALUMBO",
        "first_name": "STEPHEN",
        "credential": "REGISTERD NURSE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-03-29",
        "last_updated": "2012-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "487518",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Queens, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 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.

Verify at the official NPI Registry.