Active NPI
Jacqueline Jastram, B.S.
- Occupational Therapist
- Brooklyn, NY
National Provider Identifier
1386884336
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 007712
- Practice address
- 1073 E 72ND St
Brooklyn, NY 11234-5318 - Phone
- (917) 318-2492
- NPI assigned
- Mar 4, 2009
- Sex
- Female
- Sole proprietor
- No
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 | 007712 | NY | Primary |
Addresses
Primary practice location
1073 E 72ND St
Brooklyn, NY 11234-5318
Mailing address
1073 E 72ND St
Brooklyn, NY 11234-5318
Phone (917) 318-2492
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)
- Enrolled
- Credentials
- Bachelor of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 007712 | NY | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1236124800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1236124800000",
"number": "1386884336",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1073 E 72ND ST",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112345318",
"telephone_number": "917-318-2492"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1073 E 72ND ST",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112345318",
"telephone_number": "917-318-2492"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JASTRAM",
"first_name": "JACQUELINE",
"credential": "B.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-03-04",
"last_updated": "2009-03-04",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NY",
"license": "007712",
"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 Mar 4, 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.