Kristina Marie Vanderwall, COTA/L

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

009602 Issued in NY

Practice address

2340 Cropsey Ave
Brooklyn, NY 11214

Phone

(718) 373-1700

NPI assigned

Feb 5, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kristina Marie Buen Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1517788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546905600000",
    "number": "1306345400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2340 CROPSEY AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112145706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2340 CROPSEY AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11214",
            "telephone_number": "718-373-1700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "587 Main St",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100440096",
            "country_code": "US",
            "telephone_number": "212-223-5055",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "587 Main St",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100440096",
            "country_code": "US",
            "telephone_number": "212-223-5055",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VANDERWALL",
        "first_name": "KRISTINA",
        "middle_name": "MARIE",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-05",
        "last_updated": "2019-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "NY",
            "license": "009602",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTINA",
            "last_name": "BUEN",
            "middle_name": "MARIE",
            "credential": "COTA/L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Noah Bram Vandermark
• Timothy Vanderslice, M.D.
• Vanderveer Pharmacy Inc.
• Vanderveer RX Inc
• Theresa Maria Vanderveer-Boyd, CSW
• William Vanderwall, P.A.-C
• Kirk Vandyck
• Cecile Elizabeth Vanech, MA, PT
• Sara Vaneerde, LCSW
• Emanuel Vanegas, M.D.

• Occupational Therapy Assistant in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Occupational Therapy Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2019; 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.