Active NPI
Ellen Dvorak
- Occupational Therapist
- Cortland, NY
National Provider Identifier
1023391240
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 002260-1
- Practice address
- 1710 Nys Rte 13
Cortland, NY 13045-9617 - Phone
- (607) 758-5112
- NPI assigned
- Sep 23, 2011
- Last updated
- Sep 23, 2011
- Sex
- Female
- Sole proprietor
- No
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 | 002260-1 | NY | Primary |
Addresses
Primary practice location
1710 Nys Rte 13
Cortland, NY 13045-9617
Mailing address
1710 Nys Rte 13
Cortland, NY 13045-9617
Phone (607) 758-5112
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
| License | State | Type | Specialty |
|---|---|---|---|
| 002260-1 | NY | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1316736000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1316736000000",
"number": "1023391240",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1710 NYS RTE 13",
"city": "CORTLAND",
"state": "NY",
"postal_code": "130459617",
"telephone_number": "607-758-5112"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1710 NYS RTE 13",
"city": "CORTLAND",
"state": "NY",
"postal_code": "130459617",
"telephone_number": "607-758-5112"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DVORAK",
"first_name": "ELLEN",
"name_prefix": "Ms.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-09-23",
"last_updated": "2011-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NY",
"license": "002260-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cortland, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 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.