Individual provider Active NPI

Juliana Maria Dijkstra

  • Behavior Analyst
  • Cedarhurst, NY
National Provider Identifier
1831873082
Registry record updated Jun 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
002669 Issued in NY
Practice address
333 Pearsall Ave
Cedarhurst, NY 11516-1842
Phone
(516) 213-3338
NPI assigned
Jun 9, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 002669 NY Primary

Addresses

Primary practice location

333 Pearsall Ave
Cedarhurst, NY 11516-1842

Mailing address

99 Richmond Blvd Unit 3a
Ronkonkoma, NY 11779-3657
Phone (516) 306-5713

Other practice location 1

354 Veterans Memorial Hwy
Commack, NY 11725-4331
Phone (631) 827-2410

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
002669NYMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1686268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686268800000",
    "number": "1831873082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99 RICHMOND BLVD UNIT 3A",
            "city": "RONKONKOMA",
            "state": "NY",
            "postal_code": "117793657",
            "telephone_number": "516-306-5713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 PEARSALL AVE",
            "city": "CEDARHURST",
            "state": "NY",
            "postal_code": "115161842",
            "telephone_number": "516-213-3338"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "354 Veterans Memorial Hwy",
            "address_purpose": "LOCATION",
            "city": "Commack",
            "state": "NY",
            "postal_code": "117254331",
            "country_code": "US",
            "telephone_number": "631-827-2410",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIJKSTRA",
        "first_name": "JULIANA",
        "middle_name": "MARIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-09",
        "last_updated": "2023-06-09",
        "certification_date": "2023-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NY",
            "license": "002669",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedarhurst, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2023; 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.