Individual provider Active NPI

Isa Fannellie Murillo, LMSW

  • Social Worker
  • Bronx, NY
National Provider Identifier
1942955745
Registry record updated Feb 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
115562 Issued in NY
Practice address
6214 Riverdale Ave Ste 1a
Bronx, NY 10471-1032
Phone
(718) 701-4807
Fax
(718) 701-4807
NPI assigned
Feb 21, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 115562 NY Primary

Addresses

Primary practice location

6214 Riverdale Ave Ste 1a
Bronx, NY 10471-1032

Mailing address

6214 Riverdale Ave Ste 1a
Bronx, NY 10471-1032
Phone (718) 701-4807

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
115562NYMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1645401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645401600000",
    "number": "1942955745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6214 RIVERDALE AVE STE 1A",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104711032",
            "telephone_number": "718-701-4807",
            "fax_number": "718-701-4806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6214 RIVERDALE AVE STE 1A",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104711032",
            "telephone_number": "718-701-4807",
            "fax_number": "718-701-4807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MURILLO",
        "first_name": "ISA",
        "middle_name": "FANNELLIE",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-21",
        "last_updated": "2022-02-21",
        "certification_date": "2022-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "115562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2022; 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.