Individual provider Active NPI

Anna Kudlik

  • Occupational Therapist
  • Bronx, NY
National Provider Identifier
1457626376
Registry record updated Mar 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
015210-1 Issued in NY
Practice address
3201 Kingsbridge Ave
Bronx, NY 10463-5517
Phone
(718) 796-7204
NPI assigned
Mar 9, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 9, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 015210-1 NY Primary

Addresses

Primary practice location

3201 Kingsbridge Ave
Bronx, NY 10463-5517

Mailing address

196 Pinehurst Ave Apt 3I
New York, NY 10033-1735
Phone (212) 740-1708

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

LicenseStateTypeSpecialty
015210-1NYMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1331251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331251200000",
    "number": "1457626376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "196 PINEHURST AVE APT 3I",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100331735",
            "telephone_number": "212-740-1708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3201 KINGSBRIDGE AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104635517",
            "telephone_number": "718-796-7204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUDLIK",
        "first_name": "ANNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-03-09",
        "last_updated": "2012-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "015210-1",
            "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 Mar 9, 2012; 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.