Elizabeth Daire Fetherolf, OTR

Primary specialty

Mental Health Occupational TherapistTaxonomy code 225XM0800X

License

006105-1 Issued in NY

Practice address

3 Cliffview LN
Gardiner, NY 12525-5221

Phone

(845) 255-5394

NPI assigned

Feb 22, 2007

Last updated

Apr 1, 2011By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Welllife Network Inc.

  • Case Management Agency
  • Coram, NY
  • NPI 1386817906
  NPD (past)
• Essential Therapy Services of NJ

  • Occupational Therapist
  • Rockaway, NJ
  • NPI 1730852070
  NPD (past)

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301616000000",
    "number": "1013042175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 CLIFFVIEW LN",
            "city": "GARDINER",
            "state": "NY",
            "postal_code": "125255221",
            "telephone_number": "845-255-5394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 CLIFFVIEW LN",
            "city": "GARDINER",
            "state": "NY",
            "postal_code": "125255221",
            "telephone_number": "845-255-5394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FETHEROLF",
        "first_name": "ELIZABETH",
        "middle_name": "DAIRE",
        "name_prefix": "Ms.",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-22",
        "last_updated": "2011-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XM0800X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Mental Health",
            "state": "NY",
            "license": "006105-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Lea Deschamps
• Jennifer Dietz, LMT
• Danielle Emily Difazio
• Dr. Michael Fernandez Chiropractic, P.C.
• Rebecca Ferrante
• Vittoria Foti, LAT, ATC
• Gardiner Chiropractic PC
• Rosalie Geminiano
• Carol Johnson Giangrasso, SLP
• Patricia Jean Gorman, LCSW

• Mental Health Occupational Therapist in Gardiner, NY
• Providers in Gardiner, NY by specialty
• Mental Health Occupational Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2011; 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.