Active NPI
Martine Jolly, MA,OTR/L
- Occupational Therapist
- Brooklyn, NY
National Provider Identifier
1760635189
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 012767
- Practice address
- 3902 Avenue D
Brooklyn, NY 11203-5624 - Phone
- (718) 812-5252
- Fax
- (718) 421-3459
- NPI assigned
- Oct 29, 2008
- 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 | 012767 | NY | Primary |
Addresses
Primary practice location
3902 Avenue D
Brooklyn, NY 11203-5624
Mailing address
3902 Avenue D
Brooklyn, NY 11203
Phone (718) 812-5252
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 Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 012767 | NY | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1225238400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1225238400000",
"number": "1760635189",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3902 AVENUE D",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "11203",
"telephone_number": "718-812-5252",
"fax_number": "718-421-3459"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3902 AVENUE D",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112035624",
"telephone_number": "718-812-5252",
"fax_number": "718-421-3459"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOLLY",
"first_name": "MARTINE",
"name_prefix": "Mrs.",
"credential": "MA,OTR/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-10-29",
"last_updated": "2008-10-29",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NY",
"license": "012767",
"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 Oct 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.