Provider Demographics
NPI:1487154597
Name:FIVE STAR ASSESSMENT CORP
Entity type:Organization
Organization Name:FIVE STAR ASSESSMENT CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:VILLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-867-2143
Mailing Address - Street 1:2135 47TH STREET
Mailing Address - Street 2:SUITE 2
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11105
Mailing Address - Country:US
Mailing Address - Phone:347-867-2143
Mailing Address - Fax:
Practice Address - Street 1:2135 47 STREET
Practice Address - Street 2:SUITE 2
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11105
Practice Address - Country:US
Practice Address - Phone:347-867-2143
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-15
Last Update Date:2018-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1201XEye and Vision Services ProvidersTechnician/TechnologistOptometric AssistantGroup - Multi-Specialty
No2355A2700XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistAudiology AssistantGroup - Multi-Specialty