Active NPI
Johnhanna Jennyffer Otero
- Specialist
- Huntington Station, NY
National Provider Identifier
1518326453
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 2185275
- Practice address
- 58A E 13TH St
Huntington Station, NY 11746-2481 - Phone
- (631) 470-6169
- NPI assigned
- Feb 21, 2016
- Last updated
- Feb 21, 2016
- 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 |
|---|---|---|---|---|
| Specialist | 174400000X | 2185275 | NY | Primary |
Addresses
Primary practice location
58A E 13TH St
Huntington Station, NY 11746-2481
Mailing address
58A E 13TH St
Huntington Station, NY 11746-2481
Phone (631) 470-6169
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 |
|---|---|---|---|
| 2185275 | NY | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1456012800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1456012800000",
"number": "1518326453",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "58A E 13TH ST",
"city": "HUNTINGTON STATION",
"state": "NY",
"postal_code": "117462481",
"telephone_number": "631-470-6169"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "58A E 13TH ST",
"city": "HUNTINGTON STATION",
"state": "NY",
"postal_code": "117462481",
"telephone_number": "631-470-6169"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OTERO",
"first_name": "JOHNHANNA",
"middle_name": "JENNYFFER",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-02-21",
"last_updated": "2016-02-21",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "NY",
"license": "2185275",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Huntington Station, NY
- Cristina I. Okada Nishikawa, MS-SLP
- Taiwo Kalejaiye Olatunji-Ikuomenisan, LPN
- Aydin Mehmet Olgun, DO
- Mauricio Miguel Orellana, PHARMD
- Orthopedic Spine Care of Long Island PC
- Katie Michele Pacinelli, D.C.
- Rupali Pai, P.T.
- Pain &Rehabilitation Medicine, PLLC
- Renee Pak, PHARM D
- Christine Palazzolo, NP-C
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.