Active NPI
Justin Freitas
- Social Worker
- Bronx, NY
National Provider Identifier
1396054342
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- P77720
- Practice address
- 55 Westchester SQ
Bronx, NY 10461-3525 - Phone
- (718) 931-4045
- Fax
- (718) 828-1329
- NPI assigned
- Sep 24, 2010
- Last updated
- Sep 24, 2010
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | P77720 | NY | Primary |
Addresses
Primary practice location
55 Westchester SQ
Bronx, NY 10461-3525
Mailing address
2947 Paine St Apt 2
Bronx, NY 10461-6290
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 |
|---|---|---|---|
| P77720 | NY | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1285286400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1285286400000",
"number": "1396054342",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2947 PAINE ST APT 2",
"city": "BRONX",
"state": "NY",
"postal_code": "104616290"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "55 WESTCHESTER SQ",
"city": "BRONX",
"state": "NY",
"postal_code": "104613525",
"telephone_number": "718-931-4045",
"fax_number": "718-828-1329"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FREITAS",
"first_name": "JUSTIN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-09-24",
"last_updated": "2010-09-24",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NY",
"license": "P77720",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.