Individual provider Active NPI

Lyudmila Krupetskaya

  • Occupational Therapy Assistant
  • Brooklyn, NY
National Provider Identifier
1205070570
Registry record updated Apr 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
007252 Issued in NY
Practice address
236 Neptune Ave
Brooklyn, NY 11235-6302
Phone
(718) 769-2698
Fax
(718) 769-2317
NPI assigned
Apr 29, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 007252 NY Primary

Addresses

Primary practice location

236 Neptune Ave
Brooklyn, NY 11235-6302

Mailing address

4579 Amboy Rd
Staten Island, NY 10312-3821
Phone (718) 227-1077

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
007252NYMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1240963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240963200000",
    "number": "1205070570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4579 AMBOY RD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103123821",
            "telephone_number": "718-227-1077",
            "fax_number": "718-227-1077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "236 NEPTUNE AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112356302",
            "telephone_number": "718-769-2698",
            "fax_number": "718-769-2317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUPETSKAYA",
        "first_name": "LYUDMILA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-29",
        "last_updated": "2009-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "NY",
            "license": "007252",
            "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 Apr 29, 2009; 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.