Active NPI
Faradja Theodore
- Behavior Analyst
- Brooklyn, NY
National Provider Identifier
1861019762
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- Practice address
- 4211 Avenue K Apt 4D
Brooklyn, NY 11210-4961 - Phone
- (347) 845-3769
- NPI assigned
- Jun 26, 2020
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | |||
| Behavior Analyst | 103K00000X | DE | Primary |
Addresses
Primary practice location
4211 Avenue K Apt 4D
Brooklyn, NY 11210-4961
Mailing address
4211 Avenue K Apt 4D
Brooklyn, NY 11210-4961
Phone (347) 845-3769
Other practice location 1
4211 ave K
Apt4D
Brooklyn, NY 11210
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": "1593129600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1593129600000",
"number": "1861019762",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4211 AVENUE K APT 4D",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112104961",
"telephone_number": "347-845-3769"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4211 AVENUE K APT 4D",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112104961",
"telephone_number": "347-845-3769"
}
],
"practiceLocations": [
{
"address_1": "4211 ave K",
"address_2": "Apt4D",
"address_purpose": "LOCATION",
"city": "Brooklyn",
"state": "NY",
"postal_code": "11210",
"country_code": "US",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "THEODORE",
"first_name": "FARADJA",
"name_prefix": "Ms.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-06-26",
"last_updated": "2020-06-26",
"certification_date": "2020-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": false
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "DE",
"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 Jun 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.