Individual provider Active NPI

Lucelin Fernandez, LMT

  • Contractor
  • Copiague, NY
National Provider Identifier
1255662144
Registry record updated Jan 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ContractorTaxonomy code 171W00000X
License
021723 Issued in NY
Practice address
390 43Rd St
Copiague, NY 11726-1120
Phone
(631) 398-5829
NPI assigned
Jan 17, 2010
Last updated
Jan 17, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 17, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Contractor 171W00000X 021723 NY Primary

Addresses

Primary practice location

390 43Rd St
Copiague, NY 11726-1120

Mailing address

390 43Rd St
Copiague, NY 11726-1120
Phone (631) 398-5829

Other identifiers 1

IdentifierTypeStateIssuer
021723OtherNYNYS LICENSED MASSAGE THERAPIST

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
021723NYMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1263686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263686400000",
    "number": "1255662144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "390 43RD ST",
            "city": "COPIAGUE",
            "state": "NY",
            "postal_code": "117261120",
            "telephone_number": "631-398-5829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 43RD ST",
            "city": "COPIAGUE",
            "state": "NY",
            "postal_code": "117261120",
            "telephone_number": "631-398-5829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDEZ",
        "first_name": "LUCELIN",
        "name_prefix": "Ms.",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-01-17",
        "last_updated": "2010-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "NY",
            "license": "021723",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NYS LICENSED MASSAGE THERAPIST",
            "identifier": "021723",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Copiague, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2010; 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.