Active NPI
Crystal Janine Gobern, MS, OTR/L
- Occupational Therapist
- Bronx, NY
National Provider Identifier
1740844174
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 023573
- Practice address
- 920 Baychester Ave Apt 23H
Bronx, NY 10475-1755 - Phone
- (646) 271-6019
- NPI assigned
- May 1, 2019
- Sex
- Female
- Sole proprietor
- Yes
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 | 023573 | NY | Primary |
Addresses
Primary practice location
920 Baychester Ave Apt 23H
Bronx, NY 10475-1755
Mailing address
920 Baychester Ave Apt 23H
Bronx, NY 10475-1755
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
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 023573 | NY | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1556668800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1556668800000",
"number": "1740844174",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "920 BAYCHESTER AVE APT 23H",
"city": "BRONX",
"state": "NY",
"postal_code": "104751755"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "920 BAYCHESTER AVE APT 23H",
"city": "BRONX",
"state": "NY",
"postal_code": "104751755",
"telephone_number": "646-271-6019"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOBERN",
"first_name": "CRYSTAL",
"middle_name": "JANINE",
"name_prefix": "Ms.",
"credential": "MS, OTR/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-05-01",
"last_updated": "2019-05-01",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NY",
"license": "023573",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 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.