Individual provider Active NPI

Rita Heredia, SPECIAL EDUCATION

  • Pediatric Neurodevelopmental Disabilities Physician
  • Brooklyn, NY
National Provider Identifier
1265317127
Registry record updated Aug 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Neurodevelopmental Disabilities PhysicianTaxonomy code 2080P0008X
License
949107151 Issued in NY
Practice address
67 Manhattan Ave Apt 6S
Brooklyn, NY 11206-3126
Phone
(917) 807-5078
NPI assigned
Aug 9, 2025
Last updated
Aug 9, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Neurodevelopmental Disabilities Physician 2080P0008X 949107151 NY Primary

Addresses

Primary practice location

67 Manhattan Ave Apt 6S
Brooklyn, NY 11206-3126

Mailing address

67 Manhattan Ave Apt 6S
Brooklyn, NY 11206-3126
Phone (917) 807-5078

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
949107151NYMDPediatric Neurodevelopmental Disabilities Physician

NPI Registry JSON

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

{
    "created_epoch": "1754697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754697600000",
    "number": "1265317127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "67 MANHATTAN AVE APT 6S",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112063126",
            "telephone_number": "917-807-5078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "67 MANHATTAN AVE APT 6S",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112063126",
            "telephone_number": "917-807-5078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEREDIA",
        "first_name": "RITA",
        "credential": "SPECIAL EDUCATION",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-08-09",
        "last_updated": "2025-08-09",
        "certification_date": "2025-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0008X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neurodevelopmental Disabilities",
            "state": "NY",
            "license": "949107151",
            "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 Aug 9, 2025; 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.