Individual provider Active NPI

Juliana Siqueira Zielcke

  • Physical Therapy Assistant
  • West Orange, NJ
National Provider Identifier
1194186759
Registry record updated Apr 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
40QB00326000 Issued in NJ
Practice address
20 Summit St
West Orange, NJ 07052-1501
Phone
(973) 736-2000
NPI assigned
Mar 10, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 40QB00326000 NJ Primary

Addresses

Primary practice location

20 Summit St
West Orange, NJ 07052-1501

Mailing address

20 Summit St
West Orange, NJ 07052-1501
Phone (973) 736-2000

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
40QB00326000NJMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1457568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460073600000",
    "number": "1194186759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 SUMMIT ST",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070521501",
            "telephone_number": "973-736-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 SUMMIT ST",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070521501",
            "telephone_number": "973-736-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIELCKE",
        "first_name": "JULIANA",
        "middle_name": "SIQUEIRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-10",
        "last_updated": "2016-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NJ",
            "license": "40QB00326000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Orange, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 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.