Active NPI
Marly Johanna Wijnen, OTR
- Occupational Therapist
- Bronx, NY
National Provider Identifier
1780838490
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 005094-1
- Practice address
- 2465 Bathgate Ave
Bronx, NY 10458-5928 - Phone
- (171) 836-7591
- Fax
- (171) 836-7669
- NPI assigned
- Nov 7, 2008
- Sex
- Female
- Sole proprietor
- No
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 | 005094-1 | NY | Primary |
Addresses
Primary practice location
2465 Bathgate Ave
Bronx, NY 10458-5928
Mailing address
2465 Bathgate Ave
Bronx, NY 10458-5928
Phone (171) 836-7591
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
| License | State | Type | Specialty |
|---|---|---|---|
| 005094-1 | NY | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1226016000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1226016000000",
"number": "1780838490",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2465 BATHGATE AVE",
"city": "BRONX",
"state": "NY",
"postal_code": "104585928",
"telephone_number": "171-836-7591",
"fax_number": "171-836-7669"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2465 BATHGATE AVE",
"city": "BRONX",
"state": "NY",
"postal_code": "104585928",
"telephone_number": "171-836-7591",
"fax_number": "171-836-7669"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WIJNEN",
"first_name": "MARLY",
"middle_name": "JOHANNA",
"credential": "OTR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-11-07",
"last_updated": "2008-11-07",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NY",
"license": "005094-1",
"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 Nov 7, 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.