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1396980140 NPI number — MONIQUE ALLISIANNE WHITE OTR/L

NPI Number: 1396980140
Health Care Provider/Practitioner: MONIQUE ALLISIANNE WHITE OTR/L

Information about “1396980140” NPI (MONIQUE ALLISIANNE WHITE OTR/L) exists in 1396980140 in HTML format HTML  |  1396980140 in plain Text format TXT  |  1396980140 in PDF (Portable Document Format) PDF  |  1396980140 in an XML format XML  formats.

NPI Number : 1396980140 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1396980140",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "WHITE",
    "FirstName": "MONIQUE",
    "MiddleName": "ALLISIANNE",
    "NamePrefix": "MISS",
    "NameSuffix": null,
    "Credential": "OTR/L",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "1815 E 48TH ST",
    "SecondLineMailingAddress": "APT 2",
    "MailingAddressCityName": "BROOKLYN",
    "MailingAddressStateName": "NY",
    "MailingAddressPostalCode": "11234-3718",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "917-847-0486",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "1815 E 48TH ST",
    "SecondLinePracticeLocationAddress": "APT 2",
    "PracticeLocationAddressCityName": "BROOKLYN",
    "PracticeLocationAddressStateName": "NY",
    "PracticeLocationAddressPostalCode": "11234-3718",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "917-847-0486",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "12/09/2008",
    "LastUpdateDate": "12/09/2008",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "225XP0200X",
        "TaxonomyName": "Pediatric Occupational Therapist",
        "LicenseNumber": "012004",
        "LicenseNumberStateCode": "NY",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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