| NPI Number | 1750991089 |
| Provider Name | Isha Gurung |
| Credential | |
| Specialization | |
| Medical School Name | Other |
| Graduation Year | 2020 |
| Gender | F |
| Entity Type | Individual |
| PAC ID by PECOS | 0840691416 |
| Professional Enrollment ID | I20210702001574 |
| Enumeration Date | 08/02/2020 |
| Last Update Date | 08/02/2020 |
| Business Practice address |
9905 63RD DR APT 5P, Rego Park, 11374-2403 New York View on Google Map |
| Business Practice phone | 718-696-7511 |
| Business Practice fax | |
| Mailing address |
9905 63RD DR APT 5P, Rego Park, 11374-2403 New York View on Google Map |
| Other phone | 718-696-7511 |
| Other fax | |
| Email Address | shannonfig@domain.com Reval Email Address |
Practices in Rego Park
Rego Park, New York
Other
2020
| Organization Name | PECOS PAC ID | Members | |
|---|---|---|---|
|
Priority One Therapy Pt Ot Slp Pllc | 0941462006 | 19 |
| Field Name | Field Value |
|---|---|
| NPI | 1750991089 |
| 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. | |
| Entity Type | Individual |
Code describing the type of health care provider that is being assigned an NPI. Codes are:
|
|
| Is Sole Proprietor | Y |
Indicate whether provider is a sole proprietor.
|
|
| Provider Last Name (Legal Name) | Gurung |
| The last name of the provider (if an individual). If the provider is an individual, this is the legal name. This name must match the name on file with the Social Security Administration (SSA). In addition, the date of birth must match that on file with SSA. (First and last names are required for initial applications.) The First, Middle, Last and Credential(s) fields allow the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters. | |
| Provider First Name | Isha |
| The first name of the provider, if the provider is an individual. | |
| Provider Credential Text | OTR/L |
| The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS. | |
| Provider First Line Business Mailing Address | 9905 63RD DR APT 5P |
| The first line mailing address of the provider being identified. This data element may contain the same information as ''Provider first line location address''. | |
| Provider Business Mailing Address City Name | Rego Park |
| The City name in the mailing address of the provider being identified. This data element may contain the same information as ''Provider location address City name''. | |
| Provider Business Mailing Address State Name | New York |
| The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ''Provider location address State name''. | |
| Provider Business Mailing Address Postal Code | 11374-2403 |
| The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ''Provider location address postal code''. | |
| Provider Business Mailing Address Country Code | US |
| The country code in the mailing address of the provider being identified. This data element may contain the same information as ''Provider location address country code''. | |
| Provider Business Mailing Address Telephone Number | 718-696-7511 |
| The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ''Provider location address telephone number''. | |
| Provider First Line Business Practice Location Address | 9905 63RD DR APT 5P |
| The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box. | |
| Provider Business Practice Location Address City Name | Rego Park |
| The city name in the location address of the provider being identified. | |
| Provider Business Practice Location Address State Name | New York |
| The State or Province name in the location address of the provider being identified. | |
| Provider Business Practice Location Address Postal Code | 11374-2403 |
| The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. | |
| Provider Business Practice Location Address Country Code | US |
| The country code in the location address of the provider being identified. | |
| Provider Business Practice Location Address Telephone Number | 718-696-7511 |
| The telephone number associated with the location address of the provider being identified. | |
| Provider Enumeration Date | 08/02/2020 |
| The date the provider was assigned a unique identifier (assigned an NPI). | |
| Last Update Date | 08/02/2020 |
| The date that a record was last updated or changed. | |
| Provider Gender Code | F |
| The code designating the provider's gender if the provider is a person. | |
| Provider Gender | Female |
| The provider's gender if the provider is a person. | |
| Healthcare Provider Taxonomy Code #1 | 252Y00000X |
| The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization. | |
| Healthcare Provider Taxonomy 1 | Early intervention services are an effective way to address the needs of infants and toddlers who have developmental delays or disabilities. The services are made available through a federal law known as the Individuals with Disabilities Education Act (IDEA). IDEA provides states and territories with specific requirements for providing early intervention services to infants and toddlers with special needs. In turn, each state and territory develops its own policies for carrying out IDEA and its requirements. Broadly speaking, early intervention services are special services for eligible infants and toddlers and their families. These services are designed to identify and meet children's needs in five developmental areas. These areas are: physical development, cognitive development, communication, social or emotional development, and adaptive development. |
| Healthcare Provider Taxonomy #1 | |
| Healthcare Provider Primary Taxonomy Switch 1 | Y |
Primary Taxonomy:
|
