Individual provider Active NPI

Elizabeth Grace Berrue

  • Occupational Therapy Assistant
  • Somerset, NJ
National Provider Identifier
1841530581
Registry record updated Feb 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
46TA09089400 Issued in NJ
Practice address
380 Demott LN
Somerset, NJ 08873-2762
Phone
(732) 873-2000
Fax
(732) 873-2112
NPI assigned
Feb 17, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 46TA09089400 NJ Primary

Addresses

Primary practice location

380 Demott LN
Somerset, NJ 08873-2762

Mailing address

1940 Commerce St
Yorktown Heights, NY 10598-4428

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
46TA09089400NJMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1361059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361059200000",
    "number": "1841530581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1940 COMMERCE ST",
            "city": "YORKTOWN HEIGHTS",
            "state": "NY",
            "postal_code": "105984428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "380 DEMOTT LN",
            "city": "SOMERSET",
            "state": "NJ",
            "postal_code": "088732762",
            "telephone_number": "732-873-2000",
            "fax_number": "732-873-2112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERRUE",
        "first_name": "ELIZABETH",
        "middle_name": "GRACE",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-17",
        "last_updated": "2013-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "NJ",
            "license": "46TA09089400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerset, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2013; 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.