Individual provider Active NPI

Eileen L Gibson-Green, O.T.R./L

  • Specialist
  • Bronx, NY
National Provider Identifier
1306085824
Registry record updated Feb 5, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
0031511 Issued in NY
Practice address
3000 Bronx Park E
Apt.6C
Bronx, NY 10467-6711
Phone
(718) 652-2907
NPI assigned
Feb 5, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 5, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 0031511 NY Primary

Addresses

Primary practice location

3000 Bronx Park E
Apt.6C
Bronx, NY 10467-6711

Mailing address

3000 Bronx Park E
Apt.6C
Bronx, NY 10467-6711
Phone (718) 652-2907

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
0031511NYMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1233792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233792000000",
    "number": "1306085824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 BRONX PARK E",
            "address_2": "APT.6C",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104676711",
            "telephone_number": "718-652-2907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 BRONX PARK E",
            "address_2": "APT.6C",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104676711",
            "telephone_number": "718-652-2907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON-GREEN",
        "first_name": "EILEEN",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "O.T.R./L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-02-05",
        "last_updated": "2009-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "0031511",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 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.