Active NPI
Michelle Blumenfrucht, OTR
- Occupational Therapist
- West New York, NJ
National Provider Identifier
1356815005
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 46TR00859900
- Practice address
- 6612 Bergenline Ave
West New York, NJ 07093-1719 - Phone
- (201) 854-5511
- NPI assigned
- Jan 16, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 46TR00859900 | NJ | Primary |
Addresses
Primary practice location
6612 Bergenline Ave
West New York, NJ 07093-1719
Mailing address
411 Ogden Ave
Teaneck, NJ 07666-2819
Phone (201) 833-1968
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
| License | State | Type | Specialty |
|---|---|---|---|
| 46TR00859900 | NJ | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1547596800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1547596800000",
"number": "1356815005",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "411 OGDEN AVE",
"city": "TEANECK",
"state": "NJ",
"postal_code": "076662819",
"telephone_number": "201-833-1968"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6612 BERGENLINE AVE",
"city": "WEST NEW YORK",
"state": "NJ",
"postal_code": "070931719",
"telephone_number": "201-854-5511"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLUMENFRUCHT",
"first_name": "MICHELLE",
"credential": "OTR",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-01-16",
"last_updated": "2019-01-16",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NJ",
"license": "46TR00859900",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West New York, NJ
- Bilingual Counseling Services, LLC
- Bilingual Youth Therapeutic Services
- Christine Blanco Morel, LCSW
- Julius E Bliach, RPH
- Blossum Developmental Solutions, LLC
- Yissel Borrego, APRN
- Richard Dickran Bossbaly, CHIROPRACTOR
- Patricia Mary Boyce, WHNP
- Bridging Pathways Psychotherapy LLC
- Broadway Medical Associates LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 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.