Individual provider Active NPI

Judy Aboal

  • Student in an Organized Health Care Education/Training Program
  • Brooklyn, NY
National Provider Identifier
1336549021
Registry record updated Aug 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
102 Pilling St
Brooklyn, NY 11207-1610
Phone
(718) 602-1000
NPI assigned
Aug 29, 2014
Last updated
Aug 26, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU Primary
Case Manager/Care Coordinator 171M00000X NU

Addresses

Primary practice location

102 Pilling St
Brooklyn, NY 11207-1610

Mailing address

62 Orchard Ave
#2A
Rye, NY 10580-2806
Phone (914) 305-0022

Other practice location 1

333 Westchester Ave
#202
White Plains, NY 10604-2910
Phone (914) 328-2868

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

Practice roles

OrganizationSpecialtyStatusNew patients
New York Psychotherapy and Counseling Center CurrentSince Sep 1, 2019 Accepting new patients
Coordinated Behavioral Care Ipa Inc PastSince Sep 1, 2019 Accepting new patients

Locations

102 Pilling St
Brooklyn, NY 11207
Phone (718) 602-1000

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1409270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566777600000",
    "number": "1336549021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "62 ORCHARD AVE",
            "address_2": "#2A",
            "city": "RYE",
            "state": "NY",
            "postal_code": "105802806",
            "telephone_number": "914-305-0022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 PILLING ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112071610",
            "telephone_number": "718-602-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "333 Westchester Ave",
            "address_2": "#202",
            "address_purpose": "LOCATION",
            "city": "White Plains",
            "state": "NY",
            "postal_code": "106042910",
            "country_code": "US",
            "telephone_number": "914-328-2868",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ABOAL",
        "first_name": "JUDY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-29",
        "last_updated": "2019-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "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 26, 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.