Individual provider Active NPI

Chyniqua Hill-Liburd, LMSW

  • Early Intervention Provider Agency
  • Bronx, NY
National Provider Identifier
1073989075
Registry record updated Aug 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Early Intervention Provider AgencyTaxonomy code 252Y00000X
License
091734-1 Issued in NY
Practice address
2839 Bainbridge Ave
3B
Bronx, NY 10458-2831
Phone
(347) 597-5066
NPI assigned
Aug 13, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 13, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Early Intervention Provider Agency 252Y00000X 091734-1 NY Primary

Addresses

Primary practice location

2839 Bainbridge Ave
3B
Bronx, NY 10458-2831

Mailing address

2839 Bainbridge Ave
3B
Bronx, NY 10458-2831
Phone (347) 597-5066

Other identifiers 1

IdentifierTypeStateIssuer
252Y00000XOtherNYEARLY INTERVENTION PROVIDER AGENCY

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
091734-1NYMDEarly Intervention Provider Agency

NPI Registry JSON

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

{
    "created_epoch": "1439424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439424000000",
    "number": "1073989075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2839 BAINBRIDGE AVE",
            "address_2": "3B",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104582831",
            "telephone_number": "347-597-5066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2839 BAINBRIDGE AVE",
            "address_2": "3B",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104582831",
            "telephone_number": "347-597-5066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HILL-LIBURD",
        "first_name": "CHYNIQUA",
        "name_prefix": "Mrs.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-13",
        "last_updated": "2015-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "NY",
            "license": "091734-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EARLY INTERVENTION PROVIDER AGENCY",
            "identifier": "252Y00000X",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2015; 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.