Individual provider Active NPI

Odalys A Grullon

  • Specialist
  • Brooklyn, NY
National Provider Identifier
1841156841
Registry record updated Jan 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Practice address
44 Court St Ste 1217
Brooklyn, NY 11201-4410
Phone
(347) 479-1868
NPI assigned
Jan 2, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X NY Primary

Addresses

Primary practice location

44 Court St Ste 1217
Brooklyn, NY 11201-4410

Mailing address

44 Court St Ste 1217
Brooklyn, NY 11201-4410
Phone (347) 479-1868

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

NPI Registry JSON

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

{
    "created_epoch": "1767312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767312000000",
    "number": "1841156841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44 COURT ST STE 1217",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112014410",
            "telephone_number": "347-479-1868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44 COURT ST STE 1217",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112014410",
            "telephone_number": "347-479-1868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRULLON",
        "first_name": "ODALYS",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-01-02",
        "last_updated": "2026-01-02",
        "certification_date": "2026-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": null,
            "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 Jan 2, 2026; 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.