Peter Steven Bertuccio Jr.

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

5129 Sandlewood Dr
Holiday, FL 34690

Phone

(516) 662-4435

NPI assigned

Jul 16, 2019

Last updated

Jul 16, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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.

{
    "created_epoch": "1563235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563235200000",
    "number": "1770136012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5129 SANDLEWOOD DR",
            "city": "HOLIDAY",
            "state": "FL",
            "postal_code": "346906157",
            "telephone_number": "516-662-4435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5129 SANDLEWOOD DR",
            "city": "HOLIDAY",
            "state": "FL",
            "postal_code": "34690",
            "telephone_number": "516-662-4435"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5129 Sandalwood Dr",
            "address_purpose": "LOCATION",
            "city": "Holiday",
            "state": "FL",
            "postal_code": "346906157",
            "country_code": "US",
            "telephone_number": "516-662-4435",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERTUCCIO",
        "first_name": "PETER",
        "middle_name": "STEVEN",
        "name_suffix": "Jr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-16",
        "last_updated": "2019-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Behavior Technician in Holiday, FL
• Providers in Holiday, FL by specialty
• Behavior Technician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 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.

Verify at the official NPI Registry.