My Functional Living LLC

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

Legal business name

MY FUNCTIONAL LIVING LLC

Practice address

11 Brewster PL
Flanders, NJ 07836-9555

Phone

(862) 432-5207

NPI assigned

Jun 3, 2020

Organization subpart

No

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

Authorized official

Name

Nicole M Spaldo

Title

Owner

Phone

(862) 432-5207

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1591142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591142400000",
    "number": "1033733241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 BREWSTER PL",
            "city": "FLANDERS",
            "state": "NJ",
            "postal_code": "078369555",
            "telephone_number": "862-432-5207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 BREWSTER PL",
            "city": "FLANDERS",
            "state": "NJ",
            "postal_code": "078369555",
            "telephone_number": "862-432-5207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MY FUNCTIONAL LIVING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-03",
        "last_updated": "2020-06-03",
        "certification_date": "2020-06-03",
        "status": "A",
        "authorized_official_last_name": "SPALDO",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "862-432-5207"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Occupational Therapist in Flanders, NJ
• Providers in Flanders, NJ by specialty
• Occupational Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2020; 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.