Individual provider Active NPI

Abby Etta Winderman

  • Behavior Technician
  • Island Park, NY
National Provider Identifier
1154872265
Registry record updated Oct 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
13276 Issued in NY
Practice address
95 Ostend Rd
Island Park, NY 11558-1016
Phone
(516) 220-8480
NPI assigned
Oct 24, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 24, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X 13276 NY Primary

Addresses

Primary practice location

95 Ostend Rd
Island Park, NY 11558-1016

Mailing address

95 Ostend Rd
Island Park, NY 11558-1016
Phone (516) 220-8480

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
13276NYMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1477267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477267200000",
    "number": "1154872265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95 OSTEND RD",
            "city": "ISLAND PARK",
            "state": "NY",
            "postal_code": "115581016",
            "telephone_number": "516-220-8480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 OSTEND RD",
            "city": "ISLAND PARK",
            "state": "NY",
            "postal_code": "115581016",
            "telephone_number": "516-220-8480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINDERMAN",
        "first_name": "ABBY",
        "middle_name": "ETTA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-24",
        "last_updated": "2016-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NY",
            "license": "13276",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Island Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2016; 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.