Individual provider Active NPI

Cherry Bryan

  • Clinical Social Worker
  • Rosedale, NY
National Provider Identifier
1164875522
Registry record updated Jul 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
073560-1 Issued in NY
Practice address
24602 135TH Rd
Rosedale, NY 11422-1610
Phone
(718) 490-5297
NPI assigned
Jul 20, 2016
Last updated
Jul 20, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 073560-1 NY Primary

Addresses

Primary practice location

24602 135TH Rd
Rosedale, NY 11422-1610

Mailing address

24602 135TH Rd
Rosedale, NY 11422-1610

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
073560-1NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1468972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468972800000",
    "number": "1164875522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24602 135TH RD",
            "city": "ROSEDALE",
            "state": "NY",
            "postal_code": "114221610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24602 135TH RD",
            "city": "ROSEDALE",
            "state": "NY",
            "postal_code": "114221610",
            "telephone_number": "718-490-5297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYAN",
        "first_name": "CHERRY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-20",
        "last_updated": "2016-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "073560-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rosedale, NY

Sources for this page

Verify at the official NPI Registry.