Individual provider Active NPI

Anu Samuel, MS OTR/L

  • Pediatric Occupational Therapist
  • Queens Village, NY
National Provider Identifier
1033354436
Registry record updated Dec 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
0-12891-1 Issued in NY
Practice address
8992 Springfield Blvd
Queens Village, NY 11427-2514
Phone
(718) 740-7189
NPI assigned
Dec 13, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X 0-12891-1 NY Primary

Addresses

Primary practice location

8992 Springfield Blvd
Queens Village, NY 11427-2514

Mailing address

8992 Springfield Blvd
Queens Village, NY 11427-2514
Phone (718) 740-7189

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
0-12891-1NYMDPediatric Occupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1229126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1229126400000",
    "number": "1033354436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8992 SPRINGFIELD BLVD",
            "city": "QUEENS VILLAGE",
            "state": "NY",
            "postal_code": "114272514",
            "telephone_number": "718-740-7189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8992 SPRINGFIELD BLVD",
            "city": "QUEENS VILLAGE",
            "state": "NY",
            "postal_code": "114272514",
            "telephone_number": "718-740-7189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMUEL",
        "first_name": "ANU",
        "name_prefix": "Mrs.",
        "credential": "MS OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-13",
        "last_updated": "2008-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "NY",
            "license": "0-12891-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Queens Village, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2008; 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.