Individual provider Active NPI

Jezebel Erazo

  • Social Worker
  • Brooklyn, NY
National Provider Identifier
1972245512
Registry record updated Apr 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
112076 Issued in NY
Practice address
672 Parkside Ave FL 2
Brooklyn, NY 11226-2298
Phone
(718) 246-5700
NPI assigned
Apr 13, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 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 112076 NY Primary

Addresses

Primary practice location

672 Parkside Ave FL 2
Brooklyn, NY 11226-2298

Mailing address

2301 Brigham St FL 2
Brooklyn, NY 11229-5511
Phone (347) 587-9561

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
112076NYMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1649808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650844800000",
    "number": "1972245512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 BRIGHAM ST FL 2",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112295511",
            "telephone_number": "347-587-9561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "672 PARKSIDE AVE FL 2",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112262298",
            "telephone_number": "718-246-5700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERAZO",
        "first_name": "JEZEBEL",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-13",
        "last_updated": "2022-04-25",
        "certification_date": "2022-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "112076",
            "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 Apr 25, 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.