Individual provider Active NPI

Queen Rebecca Waljob- Harry

  • Occupational Therapist
  • Brooklyn, NY
National Provider Identifier
1740517762
Registry record updated Nov 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
6099834 Issued in NY
Practice address
9115 Avenue J
Brooklyn, NY 11236-3932
Phone
(718) 272-4424
NPI assigned
Nov 12, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 12, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 6099834 NY Primary

Addresses

Primary practice location

9115 Avenue J
Brooklyn, NY 11236-3932

Mailing address

9115 Avenue J
Brooklyn, NY 11236-3932
Phone (718) 272-4424

Other names 1

  • Mrs. Queen Rebecca Waljob-Harry Former name

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

State licenses

LicenseStateTypeSpecialty
6099834NYMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1257984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257984000000",
    "number": "1740517762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9115 AVENUE J",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112363932",
            "telephone_number": "718-272-4424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9115 AVENUE J",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112363932",
            "telephone_number": "718-272-4424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALJOB- HARRY",
        "first_name": "QUEEN",
        "middle_name": "REBECCA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-11-12",
        "last_updated": "2009-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "6099834",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "QUEEN",
            "last_name": "WALJOB-HARRY",
            "middle_name": "REBECCA",
            "prefix": "MRS.",
            "credential": "OTA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 12, 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.