Individual provider Active NPI

Daniel Joseph Prussman, LCSW

  • Clinical Social Worker
  • Brooklyn, NY
National Provider Identifier
1396046116
Registry record updated Nov 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
076534 Issued in NY
Practice address
760 Broadway
Brooklyn, NY 11206-5317
Phone
(718) 963-8825
NPI assigned
Nov 10, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 076534 NY Primary

Addresses

Primary practice location

760 Broadway
Brooklyn, NY 11206-5317

Mailing address

760 Broadway RM 3C-350
Brooklyn, NY 11206-5317
Phone (718) 963-8825

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1289347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289347200000",
    "number": "1396046116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "760 BROADWAY RM 3C-350",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112065317",
            "telephone_number": "718-963-8825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "760 BROADWAY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112065317",
            "telephone_number": "718-963-8825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRUSSMAN",
        "first_name": "DANIEL",
        "middle_name": "JOSEPH",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-11-10",
        "last_updated": "2010-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "076534",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.