Individual provider Active NPI

Cynthia Labelle Tucker

  • Specialist
  • Brooklyn, NY
National Provider Identifier
1194087429
Registry record updated Jun 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
583705051 Issued in NY
Practice address
111 Livingston St Ste 101
Brooklyn, NY 11201-5078
Phone
(718) 625-4055
Fax
(718) 625-4702
NPI assigned
Jun 12, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 12, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 583705051 NY Primary

Addresses

Primary practice location

111 Livingston St Ste 101
Brooklyn, NY 11201-5078

Mailing address

268 Eldert St
Brooklyn, NY 11207-1304
Phone (917) 753-3832

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
583705051NYMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1339459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339459200000",
    "number": "1194087429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "268 ELDERT ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112071304",
            "telephone_number": "917-753-3832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 LIVINGSTON ST STE 101",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112015078",
            "telephone_number": "718-625-4055",
            "fax_number": "718-625-4702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "CYNTHIA",
        "middle_name": "LABELLE",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-12",
        "last_updated": "2012-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "583705051",
            "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 Jun 12, 2012; 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.