Etana D Edelman

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

024899-01 Issued in NY

Practice address

655 W 254TH St
Bronx, NY 10471-1259

Phone

(201) 561-3149

NPI assigned

Oct 7, 2020

Last updated

Oct 7, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Etana D Staiman Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1602028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602028800000",
    "number": "1528665189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1935 EASTCHESTER RD APT 5F",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104612142",
            "telephone_number": "201-561-3149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 W 254TH ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104711259",
            "telephone_number": "201-561-3149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDELMAN",
        "first_name": "ETANA",
        "middle_name": "D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-07",
        "last_updated": "2020-10-07",
        "certification_date": "2020-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "NY",
            "license": "024899-01",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF NY EDUCATION DEPARTMENT",
            "identifier": "024899-01",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ETANA",
            "last_name": "STAIMAN",
            "middle_name": "D",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Temesgen Getachew Edea, MD
• Chioma Edeh, LPN
• Marsha F Edell, LCSW
• Daniel Edelman
• David Seth Edelman
• Deborah Edelstein-Weiss, SLP
• Annette L. Edelstein
• Michael Charles Edelstein, DPM
• Temituoyo Edema
• Melinda Eden

• Pediatric Occupational Therapist in Bronx, NY
• Providers in Bronx, NY by specialty
• Pediatric Occupational Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2020; 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.