Individual provider Active NPI

Allison Glickman, OTD, OTR/L

  • Occupational Therapist
  • Douglaston, NY
National Provider Identifier
1053133876
Registry record updated Apr 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
029660 Issued in NY
Practice address
24035 69TH Ave
Douglaston, NY 11362-1738
Phone
(917) 435-4804
NPI assigned
Oct 31, 2024
Last updated
Apr 8, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 8, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT4795 ME
Occupational Therapist 225X00000X 029660 NY Primary

Addresses

Primary practice location

24035 69TH Ave
Douglaston, NY 11362-1738

Mailing address

24035 69TH Ave
Douglaston, NY 11362-1738
Phone (917) 435-4804

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

LicenseStateTypeSpecialty
OT4795MEMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1730332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744070400000",
    "number": "1053133876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24035 69TH AVE",
            "city": "DOUGLASTON",
            "state": "NY",
            "postal_code": "113621738",
            "telephone_number": "917-435-4804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24035 69TH AVE",
            "city": "DOUGLASTON",
            "state": "NY",
            "postal_code": "113621738",
            "telephone_number": "917-435-4804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLICKMAN",
        "first_name": "ALLISON",
        "credential": "OTD, OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-10-31",
        "last_updated": "2025-04-08",
        "certification_date": "2025-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "ME",
            "license": "OT4795",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "029660",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Douglaston, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2025; 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.