Jarvis Paul Bullock

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

184 Eldridge St
New York, NY 10002-2924

Phone

(212) 674-9120

NPI assigned

Jan 7, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1578355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578355200000",
    "number": "1033759071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1505 METROPOLITAN AVE APT 5H",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104626147",
            "telephone_number": "203-550-2309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "184 ELDRIDGE ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100022924",
            "telephone_number": "212-674-9120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULLOCK",
        "first_name": "JARVIS",
        "middle_name": "PAUL",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-01-07",
        "last_updated": "2020-01-07",
        "certification_date": "2020-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "N/A",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1505 Metropolitan Ave Apt 5H",
            "city": "Bronx",
            "state": "NY",
            "country_code": "US",
            "postal_code": "104626147",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Amanda Bullard
• Virginia Nicole Bullington
• Alexandra Bullock
• Ashley Brown Bullock
• Isabella Bullock, PA-C
• Latoshia Bullock, M.D.
• Alison Bulman, LMSW
• Jessica Bulman, MA, CASAC-T
• Margaret Anne Bulman, PT, DPT
• William Aloysius Bulman, M.D.

• Counselor in New York, NY
• Providers in New York, NY by specialty
• Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2020; 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.