Active NPI
Guertina Derisse
- Counselor
- Brooklyn, NY
National Provider Identifier
1073218293
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- Practice address
- 1310 Rockaway Pkwy
Brooklyn, NY 11236-2339 - Phone
- (718) 272-3300
- NPI assigned
- Apr 5, 2023
- 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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | Primary |
Addresses
Primary practice location
1310 Rockaway Pkwy
Brooklyn, NY 11236-2339
Mailing address
631 E 78TH St
Brooklyn, NY 11236-3307
Phone (347) 654-4065
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1680652800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1680652800000",
"number": "1073218293",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "631 E 78TH ST",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112363307",
"telephone_number": "347-654-4065"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1310 ROCKAWAY PKWY",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112362339",
"telephone_number": "718-272-3300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DERISSE",
"first_name": "GUERTINA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-04-05",
"last_updated": "2023-04-05",
"certification_date": "2023-04-05",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.