Individual provider Active NPI

Emmanuel M Otuada, RN

  • Registered Nurse
  • Brooklyn, NY
National Provider Identifier
1659609873
Registry record updated Nov 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
579457 Issued in NY
Practice address
790 Eldert LN
16E
Brooklyn, NY 11208-4753
Phone
(917) 548-3711
Fax
(718) 235-3723
NPI assigned
Nov 29, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 29, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 579457 NY Primary

Addresses

Primary practice location

790 Eldert LN
16E
Brooklyn, NY 11208-4753

Mailing address

790 Eldert LN
16E
Brooklyn, NY 11208-4753
Phone (917) 548-3711

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
579457NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1259452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259452800000",
    "number": "1659609873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 ELDERT LN",
            "address_2": "16E",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112084753",
            "telephone_number": "917-548-3711",
            "fax_number": "718-235-3723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "790 ELDERT LN",
            "address_2": "16E",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112084753",
            "telephone_number": "917-548-3711",
            "fax_number": "718-235-3723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTUADA",
        "first_name": "EMMANUEL",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-11-29",
        "last_updated": "2009-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "579457",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2009; 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.