Active NPI
Victoria Anne Fullerton, OTR/L
- Occupational Therapist
- Brooklyn, NY
National Provider Identifier
1851960579
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 025650
- Practice address
- 65 Court St Ste 102
Brooklyn, NY 11201-4918 - Phone
- (718) 935-4000
- NPI assigned
- Jun 18, 2021
- Sex
- Female
- Sole proprietor
- Yes
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 | 025650 | NY | Primary |
Addresses
Primary practice location
65 Court St Ste 102
Brooklyn, NY 11201-4918
Mailing address
16 Rosehill Ter
Yonkers, NY 10703-1720
Phone (914) 943-8429
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 |
|---|---|---|---|
| 025650 | NY | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1623974400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1623974400000",
"number": "1851960579",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16 ROSEHILL TER",
"city": "YONKERS",
"state": "NY",
"postal_code": "107031720",
"telephone_number": "914-943-8429"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "65 COURT ST STE 102",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112014918",
"telephone_number": "718-935-4000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FULLERTON",
"first_name": "VICTORIA",
"middle_name": "ANNE",
"credential": "OTR/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-06-18",
"last_updated": "2021-06-18",
"certification_date": "2021-06-18",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NY",
"license": "025650",
"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 Jun 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.