Emma Rose Northridge

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

115 Woodstock Ave
Putnam, CT 06260-1431

Phone

(860) 888-0740

NPI assigned

Dec 3, 2024

Sex

Female

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 3, 2024.

{
    "created_epoch": "1733184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733184000000",
    "number": "1730905993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 WOODSTOCK AVE",
            "city": "PUTNAM",
            "state": "CT",
            "postal_code": "062601431",
            "telephone_number": "860-888-0740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 WOODSTOCK AVE",
            "city": "PUTNAM",
            "state": "CT",
            "postal_code": "062601431",
            "telephone_number": "860-888-0740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORTHRIDGE",
        "first_name": "EMMA",
        "middle_name": "ROSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-03",
        "last_updated": "2024-12-03",
        "certification_date": "2024-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Putnam, CT
• Behavior Technician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2024; 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.