Active NPI
Connie Shin
- Occupational Therapist
- New York, NY
National Provider Identifier
1003320896
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 022128
- Practice address
- 141 W 73Rd St
New York, NY 10023-2916 - Phone
- (877) 407-3422
- NPI assigned
- Dec 1, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 022128 | NY | Primary |
Addresses
Primary practice location
141 W 73Rd St
New York, NY 10023-2916
Mailing address
7 Carnegie PLZ
Cherry Hill, NJ 08003-1000
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 022128 | NY | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1512086400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1512086400000",
"number": "1003320896",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7 CARNEGIE PLZ",
"city": "CHERRY HILL",
"state": "NJ",
"postal_code": "080031000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "141 W 73RD ST",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100232916",
"telephone_number": "877-407-3422"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHIN",
"first_name": "CONNIE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-12-01",
"last_updated": "2017-12-01",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NY",
"license": "022128",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.