Active NPI
Charles Wiredu
- Behavior Analyst
- Bronx, NY
National Provider Identifier
1578989562
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- Practice address
- 2390 Tiebout Ave
Apt 5B
Bronx, NY 10458-7305 - Phone
- (917) 238-9506
- NPI assigned
- Mar 14, 2014
- Last updated
- Mar 14, 2014
- 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 |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | Primary |
Addresses
Primary practice location
2390 Tiebout Ave
Apt 5B
Bronx, NY 10458-7305
Mailing address
2390 Tiebout Ave
Apt 5B
Bronx, NY 10458-7305
Phone (917) 238-9506
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1394755200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1394755200000",
"number": "1578989562",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2390 TIEBOUT AVE",
"address_2": "APT 5B",
"city": "BRONX",
"state": "NY",
"postal_code": "104587305",
"telephone_number": "917-238-9506"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2390 TIEBOUT AVE",
"address_2": "APT 5B",
"city": "BRONX",
"state": "NY",
"postal_code": "104587305",
"telephone_number": "917-238-9506"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WIREDU",
"first_name": "CHARLES",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-03-14",
"last_updated": "2014-03-14",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"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 14, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.