Individual provider Active NPI

Jenine Catherine Santos Julian, MA, OTR/L, OTRP

  • Occupational Therapist
  • New York, NY
National Provider Identifier
1083324792
Registry record updated Dec 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
27467 Issued in NY
Practice address
675 3Rd Ave FL 5
New York, NY 10017-5731
Phone
(212) 922-1001
NPI assigned
Dec 5, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 27467 NY Primary

Addresses

Primary practice location

675 3Rd Ave FL 5
New York, NY 10017-5731

Mailing address

107 Mariposa Dr
Oswego, NY 13126-6735
Phone (315) 806-9404

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
27467NYMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1670198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670198400000",
    "number": "1083324792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 MARIPOSA DR",
            "city": "OSWEGO",
            "state": "NY",
            "postal_code": "131266735",
            "telephone_number": "315-806-9404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 3RD AVE FL 5",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100175731",
            "telephone_number": "212-922-1001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JULIAN",
        "first_name": "JENINE CATHERINE",
        "middle_name": "SANTOS",
        "name_prefix": "Ms.",
        "credential": "MA, OTR/L, OTRP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-05",
        "last_updated": "2022-12-05",
        "certification_date": "2022-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "27467",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2022; 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.