Individual provider Active NPI

Rita Bullock

  • Assistant Behavior Analyst
  • Valley Stream, NY
National Provider Identifier
1710444963
Registry record updated Feb 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assistant Behavior AnalystTaxonomy code 106E00000X
Practice address
1626 Putney Rd
Valley Stream, NY 11580-1818
Phone
(718) 618-5075
NPI assigned
Feb 25, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assistant Behavior Analyst 106E00000X NY Primary

Addresses

Primary practice location

1626 Putney Rd
Valley Stream, NY 11580-1818

Mailing address

17015 Lithonia Ave Apt 1
Fresh Meadows, NY 11365-1105
Phone (917) 232-6870

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": "1551052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551052800000",
    "number": "1710444963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17015 LITHONIA AVE APT 1",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113651105",
            "telephone_number": "917-232-6870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1626 PUTNEY RD",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115801818",
            "telephone_number": "718-618-5075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULLOCK",
        "first_name": "RITA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-25",
        "last_updated": "2019-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valley Stream, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2019; 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.