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1821229469 NPI number — GLEN JOSEPH SANTACROCE OTR/L, CHT

NPI Number: 1821229469
Health Care Provider/Practitioner: GLEN JOSEPH SANTACROCE OTR/L, CHT

Information about “1821229469” NPI (GLEN JOSEPH SANTACROCE OTR/L, CHT) exists in 1821229469 in HTML format HTML  |  1821229469 in plain Text format TXT  |  1821229469 in PDF (Portable Document Format) PDF  |  1821229469 in an XML format XML  formats.

NPI Number : 1821229469 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1821229469",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "SANTACROCE",
    "FirstName": "GLEN",
    "MiddleName": "JOSEPH",
    "NamePrefix": "MR.",
    "NameSuffix": null,
    "Credential": "OTR/L, CHT",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "115 MAIN ST",
    "SecondLineMailingAddress": "SUITE 202 2ND FLOOR",
    "MailingAddressCityName": "TUCKAHOE",
    "MailingAddressStateName": "NY",
    "MailingAddressPostalCode": "10707-2948",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "914-961-1010",
    "MailingAddressFaxNumber": "914-961-1011",
    "FirstLinePracticeLocationAddress": "115 MAIN ST",
    "SecondLinePracticeLocationAddress": "SUITE 202 2ND FLOOR",
    "PracticeLocationAddressCityName": "TUCKAHOE",
    "PracticeLocationAddressStateName": "NY",
    "PracticeLocationAddressPostalCode": "10707-2948",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "914-961-1010",
    "PracticeLocationAddressFaxNumber": "914-961-1011",
    "EnumerationDate": "07/30/2009",
    "LastUpdateDate": "11/06/2014",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "225X00000X",
        "TaxonomyName": "Occupational Therapist",
        "LicenseNumber": "009374-1",
        "LicenseNumberStateCode": "NY",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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