Active NPI
Cynthia A. Servello, MA, OTR
- Pediatric Occupational Therapist
- Succasunna, NJ
National Provider Identifier
1053469056
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- License
- TR 00265
- Practice address
- 151 State Hwy Route 10 East
Succasunna, NJ 07876 - Phone
- (973) 960-4001
- Fax
- (973) 252-4503
- NPI assigned
- Jan 8, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | TR 00265 | NJ | Primary |
Addresses
Primary practice location
151 State Hwy Route 10 East
Succasunna, NJ 07876
Mailing address
23 High Ave
Randolph, NJ 07869-1014
Phone (973) 366-5157
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 Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| TR 00265 | NJ | MD | Pediatric Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168214400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1053469056",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "23 HIGH AVE",
"city": "RANDOLPH",
"state": "NJ",
"postal_code": "078691014",
"telephone_number": "973-366-5157",
"fax_number": "973-252-4503"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "151 STATE HWY ROUTE 10 EAST",
"city": "SUCCASUNNA",
"state": "NJ",
"postal_code": "07876",
"telephone_number": "973-960-4001",
"fax_number": "973-252-4503"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SERVELLO",
"first_name": "CYNTHIA",
"middle_name": "A.",
"credential": "MA, OTR",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-08",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "NJ",
"license": "TR 00265",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Succasunna, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.