Individual provider Active NPI

Grace Carolina Sung, COTA/L

  • Occupational Therapy Assistant
  • Palisades Park, NJ
National Provider Identifier
1962041822
Registry record updated Dec 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
010405-01 Issued in NY
Practice address
26B Prospect St
Palisades Park, NJ 07650-1129
Phone
(201) 543-7553
NPI assigned
Dec 24, 2019
Last updated
Dec 24, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 24, 2019

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 010405-01 NY Primary

Addresses

Primary practice location

26B Prospect St
Palisades Park, NJ 07650-1129

Mailing address

26B Prospect St
Palisades Park, NJ 07650-1129
Phone (201) 543-7553

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
010405-01NYMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1577145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577145600000",
    "number": "1962041822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26B PROSPECT ST",
            "city": "PALISADES PARK",
            "state": "NJ",
            "postal_code": "076501129",
            "telephone_number": "201-543-7553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26B PROSPECT ST",
            "city": "PALISADES PARK",
            "state": "NJ",
            "postal_code": "076501129",
            "telephone_number": "201-543-7553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUNG",
        "first_name": "GRACE",
        "middle_name": "CAROLINA",
        "name_prefix": "Mrs.",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-24",
        "last_updated": "2019-12-24",
        "certification_date": "2019-12-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "NY",
            "license": "010405-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palisades Park, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 2019; 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.