Active NPI
Myriam Prud'Homme
- Occupational Therapist
- Brooklyn, NY
National Provider Identifier
1720756430
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 019758
- Practice address
- 2579 Ocean Ave FL 3
Brooklyn, NY 11229-4552 - Phone
- (646) 780-0926
- NPI assigned
- Aug 30, 2021
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 019758 | NY | Primary |
Addresses
Primary practice location
2579 Ocean Ave FL 3
Brooklyn, NY 11229-4552
Mailing address
1277 E 14TH St Apt 710a
Brooklyn, NY 11230-5289
Phone (438) 878-8030
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019758 | NY | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1630281600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1630281600000",
"number": "1720756430",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1277 E 14TH ST APT 710A",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112305289",
"telephone_number": "438-878-8030"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2579 OCEAN AVE FL 3",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112294552",
"telephone_number": "646-780-0926"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRUD'HOMME",
"first_name": "MYRIAM",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-08-30",
"last_updated": "2021-08-30",
"certification_date": "2021-08-30",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NY",
"license": "019758",
"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 Aug 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.