Individual provider Active NPI

Marla Ebonique Cirita Emilsen, MS ED

  • Intellectual Disabilities Intermediate Care Facility
  • Brooklyn, NY
National Provider Identifier
1932099454
Registry record updated Jul 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
Practice address
629 E 82ND St FL 2
Brooklyn, NY 11236-3305
Phone
(718) 877-2100
NPI assigned
Jul 7, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X Primary

Addresses

Primary practice location

629 E 82ND St FL 2
Brooklyn, NY 11236-3305

Mailing address

629 E 82ND St FL 2
Brooklyn, NY 11236-3305
Phone (718) 877-2100

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
Credentials
Master of Science

NPI Registry JSON

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

{
    "created_epoch": "1751846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751846400000",
    "number": "1932099454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "629 E 82ND ST FL 2",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112363305",
            "telephone_number": "718-877-2100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "629 E 82ND ST FL 2",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112363305",
            "telephone_number": "718-877-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EMILSEN",
        "first_name": "MARLA EBONIQUE",
        "middle_name": "CIRITA",
        "credential": "MS ED",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-07-07",
        "last_updated": "2025-07-07",
        "certification_date": "2025-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": null,
            "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 Jul 7, 2025; 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.